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Methods. Using administrative data, we identified 128 patients who underwent ostomy surgery (colostomy [ICD-9-CM 46.1X], ileostomy [46.2X], cutaneous uretero-ileostomy [56.5X], or other external urinary diversion [56.6X]) between January 1, 2008 and November 30, 2012. Based on medical record review, we then identified patients who developed PSCs within 90 days of their surgery. We then examined levels of healthcare utilization and costs over a 120-day period, beginning with the date of surgery, between patients with evidence of PSCs and those without evidence of PSCs, based on information in administrative data stores. Analyses of study data were principally descriptive in nature.
Results. Approximately one-third of study subjects (36.7%) had evidence of PSCs in the 90-day period following ostomy surgery, including 7.7% who underwent ileostomy, 35.3% who underwent colostomy, and 43.8% who underwent urinary diversion. Among patients who developed PSCs, mean (SD) time from surgery to first notation of a PSC was 23.7 (20.5) days, ranging from 22.0 (0.0) days for urinary diversion, to 23.2 (20.8) days for colostomy, and 24.2 (21.1) days for ileostomy. Patients with PSCs had longer stays in hospital for the index admission (21.5 days vs 13.9 days for those without evidence of PSCs), and once discharged were more likely to be readmitted to hospital within the observation period (47% vs 33%, respectively). Total healthcare costs over 120 days were almost $80,000 higher among patients with PSCs versus those without evidence of these complications.
Conclusions. Approximately one-third of patients with ostomies develop PSCs within 90 days of their surgery. Costs of care are substantially higher among patients who develop PSCs than they are among those without this complication.