The Economic Burden of Metabolic Syndrome in Elective Surgery: An Australian Cost-of-Illness Study

Metabolic syndrome (MetS) is common in elective surgical populations and is associated with increased postoperative complications. The national economic burden of MetS-attributable surgical morbidity in Australia has not been quantified.

A prevalence-based cost-of-illness model was constructed using Australian elective surgery volume data from the Australian Institute of Health and Welfare (2.3 million admissions, 2021-2022). MetS prevalence was modelled at 35% (sensitivity range 25%-46%). Complication risks were derived from a systematic review and meta-analysis of over 13 million surgical patients. Excess direct hospital costs were estimated from an Australian public hospital system perspective for surgical site infections, cardiovascular events, 30-day readmissions, and extended length of stay. Unit costs were obtained from the National Hospital Cost Data Collection and the Independent Hospital Pricing Authority, reported in 2023 Australian dollars. Deterministic sensitivity analysis tested model robustness.

The annual cost burden attributable to MetS was AUD 1.98 billion (95% CI: AUD 1.32-2.64 billion). Costs were driven primarily by extended length of stay (AUD 1.15 billion), followed by readmissions (AUD 345 million), cardiovascular events (AUD 243 million), and surgical site infections (AUD 242 million). Costs ranged from AUD 1.32 billion at 25% prevalence to AUD 2.64 billion at 46% prevalence. The mean additional cost per MetS surgical patient was AUD 2460.

MetS imposes a substantial direct hospital cost burden on the Australian public hospital system. These findings support evaluation of routine preoperative MetS screening and optimisation strategies.