The Price of a Whipple: Predicting Hospital Charges Using Preoperative Patient Characteristics

Area of Science:

• Hepatobiliary and Pancreatic Surgery
• Surgical Oncology
• Health Economics

Background:

• Whipple pancreaticoduodenectomy (PD) is a complex procedure with high costs.
• Postoperative complications increase healthcare expenditures.
• Few studies link preoperative factors to healthcare costs for PD.

Purpose of the Study:

• Evaluate preoperative factors predicting index admission charges for Whipple's PD.
• Assess the predictive value of baseline patient characteristics and lab tests.
• Identify modifiable indicators for cost optimization.

Main Methods:

• Retrospective review of 375 open PD patients (2018-2023).
• Analysis of preoperative demographics, comorbidities, and lab values.
• Logistic regression and Kruskal-Wallis test for cost prediction.

Main Results:

• Six lab values (WBC, hemoglobin, albumin, platelets, PT, HbA1c) predicted higher charges.
• Cumulative preoperative indicators significantly correlated with hospital charges (p=0.001).
• Patients with ≥3 adverse indicators had significantly higher charges (p<0.001).

Conclusions:

• Preoperative lab tests are significant predictors of PD hospital charges.
• Higher burden of adverse indicators correlates with increased financial charges.
• Preoperative risk stratification and optimization enhance value-based care and mitigate financial toxicity.