separate visits and prior to the adhesiolysis surgery were
not captured if specific DRG codes were not listed for
those hospitalizations [6,7,9]. Hence, this study’s estimates
of costs are likely to be conservative.
Adhesions r emain an important surgical problem, and
hospitalization for adhesiolysis leads to a high direct
cost burden in the US. Despite a trend of decreasing
LOS for adhesiolysis-related hospitalizations from 2001
to 2005, adhesiolysis-related costs continue to rise even
while the overall rate of adh esiolysis procedures remains
constant. Consistent with previous research, the distri-
bution of inpatient care a nd costs across the diagnostic
categories remained steady from 2001 to 2005 , with
only a slight increase in primary adhesiolysis procedures
over time. From 2001 to 2005, hospitalizations for adhe-
siolysis related to the digestive system and to the female
reproductive tract had the largest number of inpatient
days and accounted for the majority of costs r elated to
secondary adhesiolysis procedures.
Adhesiolysis remains a substantial economic burden to
the US health care system, which should be of interest
to providers and commercial and government payers.
Further research incorporating detailed clinical data and
indirect costs would aid in a greater understanding of
the overall burden of adhesiolysis.
This study and the preparation of this manuscript were
funded by Ethicon, Inc. The authors acknowledge that
Ethicon, Inc. is the maker of GYNECARE INTERCEED,
a product that is marketed to prevent pelvic adhesions.
Portions of the study data presented in this paper were previously
presented as a podium presentation at the VIII
PAX Meeting; Clermont-
Ferrand, France; September 18-20, 2008, as well as a poster presentation at
Annual Clinical Meeting of the American College of Obstetricians
and Gynecologists; Chicago, Illinois; May 2-6, 2009.
The authors wish to thank Ms. Gail Zona of RTI Health Solutions and Ms.
Heidi Waters of Ethicon, Inc., for assistance with preparing this manuscript.
Shire Pharmaceuticals, Wayne, PA 19087 USA.
RTI Health Solutions, 200
Park Offices, Research Triangle Park, NC 27709 USA.
The Christie NHS
Foundation Trust, Manchester, M20 4BX, UK.
Texas Health Care, Fort Worth,
TX 76109 USA.
VS was responsible for developing the study design, interpreting the analysis
results, and drafting the manuscript text; he is the primary author of this
manuscript. BB, SDC, and KLD were responsible for the acquisition,
management, inter pretation, and analysis of all study data. BB, SDC, and KLD
also assisted with developing the study design, interpreting the analysis
results, and drafting the manuscript. AJ and MW contributed clinical
expertise and guidance and assisted in interpreting the analysis results and
drafting the manuscript text.
All authors confirm that they have read the journal’s position on issues
involved in ethical publication and affirm that this research report is
consistent with those guidelines. Finally, all authors have read and approved
the final manuscript.
VS was an employee of Ethicon, Inc. at the time that this manuscript was
prepared; he is currently an employee of Shire Pharmaceuticals. BB, SDC, and
KLD are employees of RTI Health Solutions, the research organization
contracted by Ethicon to conduct this study. AJ is an employee of Texas
Healthcare; MW is an employee of Christie NHS Foundation Trust.
Received: 5 January 2011 Accepted: 9 June 2011 Publi shed: 9 June 2011
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Cite this article as: Sikirica et al.: The inpatient burden of abdominal and
gynecological adhesiolysis in the US. BMC Surgery 2011 11:13.
Sikirica et al. BMC Surgery 2011, 11:13
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