Background
Although sarcopenia has been identified as a predictor of poor, postoperative, clinical
outcomes, the financial impact of sarcopenia remains undetermined. We sought to evaluate
the relationship between sarcopenia and hospital finances among a cohort of patients
undergoing a hepato-pancreatico-biliary or colorectal resection.
Methods
Clinical, financial, and morphometric data were collected for 1,169 patients undergoing
operative resection between January 2011 and December 2013 at the Johns Hopkins Hospital.
Multivariable regression analysis was performed to assess the relationship between
sarcopenia and total hospital costs.
Results
Using sex-specific cutoffs for total psoas volume, 293 patients were categorized as
sarcopenic. The presence of sarcopenia was associated with a $14,322 increase in the
total hospital cost (median covariate-adjusted cost, sarcopenia versus no sarcopenia:
$38,804 vs $24,482, P < .001). Patients who presented with sarcopenia demonstrated a higher total hospital
cost within the subgroup of patients who developed a postoperative complication (sarcopenia
versus no sarcopenia: $65,856 vs $59,609) and among those patients who did not develop
a postoperative complication (sarcopenia versus no sarcopenia: $26,282 vs $23,763,
both P < .001). Similarly, total hospital costs were higher among patients presenting with
sarcopenia regardless of the length of stay for index admission (observed:expected,
length of stay < 1: sarcopenia versus no sarcopenia: $25,038 vs $22,827; observed:expected,
length of stay > 1: sarcopenia versus no sarcopenia: $43,283 vs $38,679, both P < .001).
Conclusion
As measured by sarcopenia, patient frailty is inversely related to total hospital
costs. Sarcopenia represents a novel tool for forecasting patient outcomes and operative
costs and can be used to inform quality improvement and cost containment strategies.
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Article info
Publication history
Published online: June 11, 2016
Accepted:
May 3,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
