By Any Other Name: Bowel Dysfunction After Proctectomy for Cancer and Its Predictive Factors in Administrative Databases
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View abstract on PubMed
Summary
This summary is machine-generated.Bowel dysfunction affects nearly 40% of cancer proctectomy patients, with chemotherapy increasing risk. This condition significantly doubles post-operative healthcare costs.
Area Of Science
- Colorectal surgery outcomes
- Gastrointestinal oncology
- Health services research
Background
- Bowel dysfunction after proctectomy for cancer is poorly understood in population studies.
- Lack of specific administrative codes hinders analysis of low anterior resection syndrome.
- This study aimed to define and analyze bowel dysfunction phenotypes in claims data.
Purpose Of The Study
- Identify a bowel dysfunction phenotype in administrative claims data.
- Characterize the prevalence and predictive factors of bowel dysfunction post-proctectomy.
- Assess the associated healthcare costs of bowel dysfunction.
Main Methods
- Retrospective cohort study using employer-sponsored insurance claims (MarketScan).
- Defined bowel dysfunction by diagnostic codes for diarrhea, constipation, or incontinence within 18 months post-surgery.
- Used Poisson regression to identify predictors and compared healthcare costs.
Main Results
- 39.7% of 2131 cancer proctectomy patients experienced bowel dysfunction within 18 months.
- Constipation (53.5%) and diarrhea (40.3%) were most common; diagnostic/rehabilitative procedures were underutilized (29.8%).
- Neoadjuvant chemotherapy (with or without radiation) predicted dysfunction; median costs were $30,769 higher for affected patients (P < 0.001).
Conclusions
- Over one-third of patients develop symptomatic bowel dysfunction within 18 months of proctectomy.
- Multiagent chemotherapy is the strongest predictor of postoperative bowel dysfunction.
- Bowel dysfunction more than doubles postoperative healthcare costs.
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