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Open Access Research article

The inpatient burden of abdominal and gynecological adhesiolysis in the US

Vanja Sikirica1, Bela Bapat2, Sean D Candrilli2*, Keith L Davis2, Malcolm Wilson3 and Alan Johns4

Author Affiliations

1 Shire Pharmaceuticals, Wayne, PA 19087 USA

2 RTI Health Solutions, 200 Park Offices, Research Triangle Park, NC 27709 USA

3 The Christie NHS Foundation Trust, Manchester, M20 4BX, UK

4 Texas Health Care, Fort Worth, TX 76109 USA

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BMC Surgery 2011, 11:13  doi:10.1186/1471-2482-11-13

Published: 9 June 2011

Abstract

Background

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