Alvimopan reduces length of stay and costs in patients undergoing segmental colonic resections

Results from multicenter national administrative database

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, has been shown to expedite recovery of bowel function after colon resection surgery. Most data are available from industry-sponsored trials. This study aims to evaluate the clinical impact of this drug on perioperative outcomes and costs in patients undergoing segmental colonic resection for diverticular disease.

Methods A large administrative database maintained by the University Health System Consortium, an alliance of over 200 academic and affiliate hospitals, was queried from 2008 to 2011. International Classification of Diseases, 9th Revision, Clinical Modification codes for segmental colon resection because of diverticular disease were used to identify 2 matched cohorts of adult patients. University Health System Consortium's clinical resource manager was used to access pharmacy data and compare it with patient outcomes.

Results Five thousand two hundred ninety-nine patients met the above criteria. Four hundred thirty-eight patients received alvimopan and 4,861 did not. Regardless of laparoscopic or open approach, alvimopan significantly improved the postoperative length of stay (4.43 ± 2.02 vs 5.92 ± 3.79, P <.0001), cost (9,974 ± 4,077 vs 11,303 ± 6,968, P <.0001), and intensive care unit admission rate (1.83% vs 7.20%, P <.05), with no significant difference in mortality (.0% vs.19%, P = 1.000), morbidity (5.93% vs 8.39%, P =.08), or 30-day readmission rate (4.40% vs 4.63%, P =.90).

Conclusions Alvimopan significantly reduced length of stay, days in the intensive care unit, and hospital cost for patients undergoing colonic segmental resections. Unlike some previously reported studies, we also observed a significant reduction in the length of stay in patients undergoing laparoscopic colectomies who received the drug. Alvimopan may reduce total healthcare costs if used as part of a best care practice model for colon resections.

Original languageEnglish (US)
Pages (from-to)919-925
Number of pages7
JournalAmerican journal of surgery
Volume208
Issue number6
DOIs
StatePublished - Dec 1 2014

Fingerprint

alvimopan
Length of Stay
Databases
Costs and Cost Analysis
Colon
Intensive Care Units
Narcotic Antagonists
Colectomy
Hospital Costs
mu Opioid Receptor
Recovery of Function
Health
International Classification of Diseases
Practice Guidelines
Pharmaceutical Preparations
Health Care Costs
Industry

Keywords

  • Alvimopan
  • Colon
  • Database
  • Outcomes
  • Resection
  • Sigmoidectomy

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

@article{d326f7c7b45d4093b8e7acbd3a38fbda,
title = "Alvimopan reduces length of stay and costs in patients undergoing segmental colonic resections: Results from multicenter national administrative database",
abstract = "Background Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, has been shown to expedite recovery of bowel function after colon resection surgery. Most data are available from industry-sponsored trials. This study aims to evaluate the clinical impact of this drug on perioperative outcomes and costs in patients undergoing segmental colonic resection for diverticular disease.Methods A large administrative database maintained by the University Health System Consortium, an alliance of over 200 academic and affiliate hospitals, was queried from 2008 to 2011. International Classification of Diseases, 9th Revision, Clinical Modification codes for segmental colon resection because of diverticular disease were used to identify 2 matched cohorts of adult patients. University Health System Consortium's clinical resource manager was used to access pharmacy data and compare it with patient outcomes.Results Five thousand two hundred ninety-nine patients met the above criteria. Four hundred thirty-eight patients received alvimopan and 4,861 did not. Regardless of laparoscopic or open approach, alvimopan significantly improved the postoperative length of stay (4.43 ± 2.02 vs 5.92 ± 3.79, P <.0001), cost (9,974 ± 4,077 vs 11,303 ± 6,968, P <.0001), and intensive care unit admission rate (1.83{\%} vs 7.20{\%}, P <.05), with no significant difference in mortality (.0{\%} vs.19{\%}, P = 1.000), morbidity (5.93{\%} vs 8.39{\%}, P =.08), or 30-day readmission rate (4.40{\%} vs 4.63{\%}, P =.90).Conclusions Alvimopan significantly reduced length of stay, days in the intensive care unit, and hospital cost for patients undergoing colonic segmental resections. Unlike some previously reported studies, we also observed a significant reduction in the length of stay in patients undergoing laparoscopic colectomies who received the drug. Alvimopan may reduce total healthcare costs if used as part of a best care practice model for colon resections.",
keywords = "Alvimopan, Colon, Database, Outcomes, Resection, Sigmoidectomy",
author = "Anton Simorov and Thompson, {Jon S} and Dmitry Oleynikov",
year = "2014",
month = "12",
day = "1",
doi = "10.1016/j.amjsurg.2014.08.011",
language = "English (US)",
volume = "208",
pages = "919--925",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
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T1 - Alvimopan reduces length of stay and costs in patients undergoing segmental colonic resections

T2 - Results from multicenter national administrative database

AU - Simorov, Anton

AU - Thompson, Jon S

AU - Oleynikov, Dmitry

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Background Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, has been shown to expedite recovery of bowel function after colon resection surgery. Most data are available from industry-sponsored trials. This study aims to evaluate the clinical impact of this drug on perioperative outcomes and costs in patients undergoing segmental colonic resection for diverticular disease.Methods A large administrative database maintained by the University Health System Consortium, an alliance of over 200 academic and affiliate hospitals, was queried from 2008 to 2011. International Classification of Diseases, 9th Revision, Clinical Modification codes for segmental colon resection because of diverticular disease were used to identify 2 matched cohorts of adult patients. University Health System Consortium's clinical resource manager was used to access pharmacy data and compare it with patient outcomes.Results Five thousand two hundred ninety-nine patients met the above criteria. Four hundred thirty-eight patients received alvimopan and 4,861 did not. Regardless of laparoscopic or open approach, alvimopan significantly improved the postoperative length of stay (4.43 ± 2.02 vs 5.92 ± 3.79, P <.0001), cost (9,974 ± 4,077 vs 11,303 ± 6,968, P <.0001), and intensive care unit admission rate (1.83% vs 7.20%, P <.05), with no significant difference in mortality (.0% vs.19%, P = 1.000), morbidity (5.93% vs 8.39%, P =.08), or 30-day readmission rate (4.40% vs 4.63%, P =.90).Conclusions Alvimopan significantly reduced length of stay, days in the intensive care unit, and hospital cost for patients undergoing colonic segmental resections. Unlike some previously reported studies, we also observed a significant reduction in the length of stay in patients undergoing laparoscopic colectomies who received the drug. Alvimopan may reduce total healthcare costs if used as part of a best care practice model for colon resections.

AB - Background Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, has been shown to expedite recovery of bowel function after colon resection surgery. Most data are available from industry-sponsored trials. This study aims to evaluate the clinical impact of this drug on perioperative outcomes and costs in patients undergoing segmental colonic resection for diverticular disease.Methods A large administrative database maintained by the University Health System Consortium, an alliance of over 200 academic and affiliate hospitals, was queried from 2008 to 2011. International Classification of Diseases, 9th Revision, Clinical Modification codes for segmental colon resection because of diverticular disease were used to identify 2 matched cohorts of adult patients. University Health System Consortium's clinical resource manager was used to access pharmacy data and compare it with patient outcomes.Results Five thousand two hundred ninety-nine patients met the above criteria. Four hundred thirty-eight patients received alvimopan and 4,861 did not. Regardless of laparoscopic or open approach, alvimopan significantly improved the postoperative length of stay (4.43 ± 2.02 vs 5.92 ± 3.79, P <.0001), cost (9,974 ± 4,077 vs 11,303 ± 6,968, P <.0001), and intensive care unit admission rate (1.83% vs 7.20%, P <.05), with no significant difference in mortality (.0% vs.19%, P = 1.000), morbidity (5.93% vs 8.39%, P =.08), or 30-day readmission rate (4.40% vs 4.63%, P =.90).Conclusions Alvimopan significantly reduced length of stay, days in the intensive care unit, and hospital cost for patients undergoing colonic segmental resections. Unlike some previously reported studies, we also observed a significant reduction in the length of stay in patients undergoing laparoscopic colectomies who received the drug. Alvimopan may reduce total healthcare costs if used as part of a best care practice model for colon resections.

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KW - Database

KW - Outcomes

KW - Resection

KW - Sigmoidectomy

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