Costs and length of stay for patients with and without sickle cell disease after hysterectomy, appendectomy, or knee replacement

Patients with sickle cell disease (SCD) who undergo surgical procedures experience greater risk for preoperative and postoperative complications than patients without SCD; however, the impact of SCD on inpatient resource use and costs had not been reported [ 1 – 7 ]. We recently examined inpatient length of stay and total costs for patients with and without SCD who underwent cholecystectomy or hip replacement and found that patients with SCD had longer lengths of stay and incurred higher costs [ 8 ]. In this study, we extend our previous work to surgical procedures that are less commonly performed in patients with SCD: hysterectomy, appendectomy, and knee replacement. Using a large national database of inpatient stays, we found that patients with SCD had significantly longer lengths of stay and incurred higher costs than patients without SCD who underwent the same procedures, after adjustment for patient, hospital, and procedural characteristics ( P < 0.001). Higher inpatient costs were largely attributable to longer hospital stays. Future work should investigate the extent to which preoperative and postoperative complications and other factors contribute to longer stays among patients with SCD and how these factors might be addressed.