Economic Consequences of Surgery for Adhesive Small Bowel Obstruction: A Population-Based Study

Area of Science:

• Gastroenterology
• Health Economics
• Surgical Outcomes

Background:

• Adhesions are common after abdominal surgery, leading to small bowel obstruction (SBO) in some patients.
• SBO often requires hospitalization and surgery, incurring substantial costs.
• Recent data on the direct costs of SBO surgery and follow-up are limited.

Purpose of the Study:

• To determine the direct costs associated with small bowel obstruction (SBO) surgery and follow-up.
• To analyze the relationship between SBO costs and perioperative factors.
• To provide population-based cost data for SBO management.

Main Methods:

• Retrospective cohort study of 402 patients operated for adhesive SBO.
• Data collected from Gävleborg and Uppsala counties, Sweden (2007-2012).
• Costs calculated using Uppsala University Hospital pricelist; median follow-up of 8 years.

Main Results:

• Total costs reached €16.267 million, with a mean of €40,467 per patient.
• Diffuse adhesions and postoperative complications significantly increased SBO costs (P < 0.001).
• In-hospital stay was the primary cost driver, accounting for 70% of total expenses (€14 million during the index surgery period).

Conclusions:

• Small bowel obstruction surgery imposes a considerable economic burden on healthcare systems.
• Strategies reducing SBO incidence, postoperative complications, or length of stay can mitigate costs.
• Cost estimates are valuable for future cost-benefit analyses of SBO interventions.