Cost burden following esophagectomy: A single centre observational study

Figure 1 Mediation effects analysis model. a: The effect of drivers of hospital costs on other drivers of hospital costs; b: The effect on hospital costs; c’: The direct effect of drivers of hospital costs on hospital costs adjusted to the mediator (c - ab); c: The total hospital costs, including the mediator variables. The indirect effect is the product of coefficients a and b (ab) and the difference between the c coefficient and c’ coefficient (c-c’).

Figure 2 Unadjusted cost. A: Unadjusted cost comparison by the severity of complications. A line indicates the median, and a dashed line indicates the 1^st and 3^rd quartiles. The height of each graph indicates the maximum cost range, and the width of each graph plots the kernel density estimate. Kruskal-Wallis rank sum test: Χ² = 37.843, df = 3, P < 0.001. Pairwise comparisons using the Wilcoxon rank sum test with continuity correction. ^aP < 0.05 vs no complication or CD I, ^bP < 0.05 vs CD II, ^cP < 0.05 vs CD III; B: Unadjusted cost comparison by the number of complications. A line indicates the median, and a dashed line indicates the 1^st and 3^rd quartiles. The height of each graph indicates the maximum cost range, and the width of each graph plots the kernel density estimate. Kruskal-Wallis rank sum test: Χ² = 47.606, df = 2, P < 0.001. Pairwise comparisons using the Wilcoxon rank sum test with continuity correction. ^aP < 0.05 vs 0-3 complications, ^bP < 0.05 vs 4-7 complications, ^cP < 0.05 vs higher number of complications more than 7; C: Unadjusted hospital costs between the patients with and without esophagectomy specific complications. A line indicates the median and dashed line indicates the 1^st and 3^rd quartiles. The height of each graph indicates maximum cost range, and the width of each graph plots the kernel density estimate. Wilcoxon rank sum test with continuity correction. W = 400, P < 0.001. ^aP < 0.05.

Figure 3 Mediation analyses for complications. A: Mediation analyses for severity of complications. The indirect, mediator adjusted direct, and the total effects are presented; B: Mediation analyses for the number of complications. The indirect, mediator adjusted direct, and the total effects are presented; C: Mediation analyses for esophagectomy key complications. The indirect, mediator adjusted direct, and the total effects are presented. ^aP < 0.05; ICU: Intensive care unit; HDU: High dependency unit; LOS: RBC: ASA: American Society of Anesthesiology; CCI: Charlson comorbidity index; CD: Clavien-Dindo.