Perioperative medicine & outcomes
Association of reintubation and hospital costs and its modification by postoperative surveillance: A multicenter retrospective cohort study
Main finding · Direct hospital costsResult — go to the resultAdjusted model estimate 2.05 95% CI 2.00–2.10Authors' conclusion
Postoperative reintubation is associated with 2-fold higher hospital costs. Prolonged surveillance in the recovery room mitigated this effect.
Study context
- Population
- Adult non-cardiac surgical patients under GA, 2016–2021, two tertiary academic networks in the Bronx, New York and Boston, Massachusetts, US
- Participants
- 68,125 participants
- Exposure
- Unplanned reintubation within 7 days of surgery vs no reintubation
- Reintubationn = 1,759
- Outcome
- Direct hospital costs associated with patient care related activities
Methodological detailsmulticentre, multivariable generalized linear model, Healthcare Cost and Utilization Project-National Inpatient Sample (HCUP-NIS) matched cohort
- Multicentre
- Multivariable generalized linear model
- HCUP-NIS matched cohort
Main finding
Direct hospital costs
Adjusted model estimate
2.05
95% CI 2.00–2.10
As reported in the abstract
- Adjusted absolute difference in costs, reintubation vs no reintubation (HCUP-NIS matched cohort)
- US$ 18,837 (95% CI: 17,921-19,777)
Observational data: associations, not effects.
Further findings
| Outcome | Shorter PACU LOS | Longer PACU LOS | Adjusted absolute difference (US$) (95% CI) | P value |
|---|---|---|---|---|
| Modification of reintubation–cost association by PACU surveillance (≥4 h)Reintubation, shorter PACU LOS vs No reintubation | 23,444 (21,217–25,799) | |||
| Modification of reintubation–cost association by PACU surveillance (≥4 h)Reintubation, longer PACU LOS vs No reintubation | 17,615 (16,350–18,926) | |||
| Timing of reintubation by PACU LOS (subgroup) | median 2 (IQR 1–5) days | 1 (IQR 0–2) days | P < 0.001 |
- Modification of reintubation–cost association by post-anesthesia care unit (PACU) surveillance (≥4 h): p-for-interaction <0.001
- Modification of reintubation–cost association by PACU surveillance (≥4 h): shorter vs longer PACU stay p < .001
Original publication
Association of reintubation and hospital costs and its modification by postoperative surveillance: A multicenter retrospective cohort study. J Clin Anesth. Published 16 September 2023. doi:10.
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