Risk and Economic Burden of Peristomal Skin Complications Following Ostomy Surgery.
Charu Taneja, Debra Netsch, Bonnie Sue Rolstad and 3 others
PMID 30844870WHAT IT FOUND
Average 120-day costs were $58,329 for 61 ostomy patients with peristomal skin complications and $50,928 for 107 without, but the study did not show that costs differed. 36.3% had complications within 90 days, and those with complications were readmitted more often, 55.7% vs 35.5%.
Key findings
0161 of 168 ostomy patients (36.3%) had a peristomal skin complication within 90 days of surgery.
02Patients with peristomal skin complications were rehospitalized more often during 120 days after surgery (55.7% vs 35.5%).
03Mean total 120-day healthcare cost was $58,329 for patients with complications and $50,928 for those without, but the study did not show that costs differed (P = .25).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The authors stated that the sample size was small and statistical power was low, so apparent differences may be noise. The study was retrospective and used chart review plus claims data, so records may be incomplete, variable, or hard to interpret. Patients with complications may differ in surgical technique, effluent characteristics, stoma characteristics, body mass index, and comorbid illness, so the higher readmission rate may reflect confounding rather than the complication itself. Visits and costs were counted for all reasons, not only for skin complications, so the study cannot say how much spending was caused by the complications. Only Geisinger Health Plan members who survived and stayed enrolled for 120 days were included, which may limit generalizability to other patients and health systems. Follow-up was limited to 120 days and stoma closure removed patients from further complication risk, so later complications and long-term costs were not captured.
The easy way to misread this
Do not read the 55.7% versus 35.5% readmission difference as proof that peristomal skin complications caused readmission. The study was observational, patients with complications may differ in other ways, and the study did not show that costs differed.