Financial burden of complications in lung resection surgery: scoping review

Abstract

Background Lung resection surgery is a common procedure in the treatment of lung cancer. It has been associated with a high cost burden, with complications considered a substantial contributor to associated expenses. This review sought to understand and describe the financial burden associated with complications of lung resection surgery.Methods Key databases (Ovid MEDLINE and Embase, Cochrane CENTRAL) were searched up to 14 October 2024. Studies reporting on costs of at least one complication of lung resection surgery, including lobectomy, wedge resection, segmentectomy, sleeve resection, pneumonectomy, or a combination of these, were included. Following identification of eligible articles, all relevant data were extracted. Quality assessment tools, including the Scottish Intercollegiate Guidelines Network Checklists for Economic Evaluations and Cohort Studies and the Risk Of Bias In Non-randomized Studies-of Interventions tool, were used to confirm articles for inclusion.Results In all, 31 articles were identified for inclusion: 2 prospective and 29 retrospective studies. All lung-specific complications and all but one non-pulmonary complication were associated with increased hospitalization costs. Hospital expenses also increased with increasing numbers and grades of complications.Conclusion Substantial variation in the definitions of costs and complications across studies has rendered a comparison of findings between studies challenging. Greater uniformity in definitions and classifications of costs and complications in future studies will facilitate further characterization of the cost burden of specific complications. Lung resection surgery is a common procedure in the treatment of lung cancer and has been associated with a high cost burden, with complications considered a substantial contributor to associated hospital costs. This review summarized the body of published literature on the cost burden associated with complications of lung resection surgery. It demonstrated that all lung-specific complications and all but one non-pulmonary complication were associated with increased hospital costs. However, substantial variation was observed in the definitions of costs and complications across studies, which has rendered a comparison of findings between studies challenging. Greater uniformity in definitions and classifications of costs and complications in future studies will facilitate further characterization of the cost burden of specific complications.