Disclosures: Hshieh reports no relevant financial disclosures.
March 11, 2021
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Delirium led to higher health care costs after major elective surgery

Disclosures: Hshieh reports no relevant financial disclosures.
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Delirium and severe delirium after major elective surgery led to significantly higher health care costs, with most costs attributed to the first 90 days of care, according to published results.

Tammy T. Hshieh, MD, MPH, and colleagues examined cumulative and period-specific costs among 497 patients who did (n=122) and those who did not (n=375) develop delirium after major elective surgery. Researchers determined total inflation-adjusted health care costs using data from Medicare administrative claims files for the 2010 to 2014 period. Using the confusion assessment method, researchers rated delirium and examined whether increasing delirium severity was associated with higher cumulative and period-specific costs.

Gou graphic
Postoperative delirium attributed an estimated $32.9 billion per year in health care costs in the US. Data were derived from Gou RY, et al. JAMA Surg. 2021;doi:10.1001/jamasurg.2020.7260.

Results showed significantly higher unadjusted health care costs among patients with delirium vs. patients without delirium. Researchers found cumulative health care costs attributable to delirium were $44,291 per patient per year. Most of the costs came from the first 90 days, including index hospitalization, subsequent rehospitalizations and post-acute rehabilitation stays, according to results. Researchers found a direct and significant increase in health care costs as level of delirium severity increased, with adjusted mean cumulative costs attributable to severe delirium of $56,474 per patient per year. When extrapolated nationally, results showed $32.9 billion per year in health care costs were estimated to be attributed to postoperative delirium.

Tammy T. Hshieh
Tammy T. Hshieh

“Delirium and severe delirium after elective surgery have substantial economic impacts on the United States health care system,” Hshieh, of the division of aging at Brigham and Women’s Hospital, Older Adult Hematologic Malignancy Program at the Dana-Farber Cancer Institute and assistant profess of medicine at Harvard Medical School, told Healio Orthopedics. “Our study shows the economic impact of postoperative delirium rivals the annual costs associated with cardiovascular disease and diabetes. Because postoperative delirium potentially costs the health care system $33 billion per year, delirium is a large-scale public health issue that warrants efforts to bolster prevention, early detection and management.”