The inpatient burden of abdominal and gynecological adhesiolysis in the US

BMC Surg. 2011; 11: 13.
Published online 2011 June 9. doi: 10.1186/1471-2482-11-13 PMCID: PMC3141363

Copyright ©2011 Sikirica et al; licensee BioMed Central Ltd.
The inpatient burden of abdominal and gynecological adhesiolysis in the US
Vanja Sikirica,1 Bela Bapat,2 Sean D Candrilli,2 Keith L Davis,2 Malcolm Wilson,3 and Alan Johns4
1Shire Pharmaceuticals, Wayne, PA 19087 USA
2RTI Health Solutions, 200 Park Offices, Research Triangle Park, NC 27709 USA
3The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
4Texas Health Care, Fort Worth, TX 76109 USA
Corresponding author.
Vanja Sikirica: vsikirica@shire.com; Bela Bapat: bbapat@rti.org; Sean D Candrilli: scandrilli@rti.org; Keith L Davis: kldavis@rti.org; Malcolm Wilson: Malcolm.Wilson@christie.nhs.uk; Alan Johns: daj@womenssurgerygroup.com
Received January 5, 2011; Accepted June 9, 2011.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Other Sections▼
AbstractBackgroundMethodsResults and DiscussionConclusionsCompeting interestsAuthors' contributionsFundingPre-publication historyReferencesAbstractBackground
Adhesions are fibrous bands of scar tissue, often a result of surgery, that form between internal organs and tissues, joining them together abnormally. Postoperative adhesions frequently occur following abdominal surgery, and are associated with a large economic burden. This study examines the inpatient burden of adhesiolysis in the United States (i.e., number and rate of events, cost, length of stay [LOS]).Methods
Hospital discharge data for patients with primary and secondary adhesiolysis were analyzed using the 2005 Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. Procedures were aggregated by body system.Results
We identified 351,777 adhesiolysis-related hospitalizations: 23.2% for primary and 76.8% for secondary adhesiolysis. The average LOS was 7.8 days for primary adhesiolysis. We found that 967,332 days of care were attributed to adhesiolysis-related procedures, with inpatient expenditures totaling $2.3 billion ($1.4 billion for primary adhesiolysis; $926 million for secondary adhesiolysis). Hospitalizations for adhesiolysis increased steadily by age and were higher for women. Of secondary adhesiolysis procedures, 46.3% involved the female reproductive tract, resulting in 57,005 additional days of care and $220 million in attributable costs.Conclusions
Adhesiolysis remain an important surgical problem in the United States. Hospitalization for this condition leads to high direct surgical costs, which should be of interest to providers and payers.Keywords: Adhesions, adhesiolysis, abdominal, gynecological, burden of illness, hospitalizations.
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