Financial Toxicity in Complex Gastrointestinal Surgery and Correlation With Patient-reported Outcomes.

Abstract

To describe financial toxicity (FT) in patients who have undergone gastrointestinal (GI) surgery and its correlation with patients' emotional (EWB) and social (SWB) well-being. FT describes the financial burden associated with treatment and its impact on patient outcomes. Few prior studies have examined FT in GI surgery and its impact on patient quality of life. Patients who underwent GI surgery at our institution were assessed for FT with a validated instrument between January 2022 and January 2023. EWB and SWB were assessed with a validated instrument. Risk factors for FT were determined using a multivariable model. The correlation between FT and patient EWB and SWB was assessed using Pearson correlation. A total of 188 patients were surveyed, the majority had pancreatic resections (n = 90, 47.9%), and 59 (31.4%) patients experienced FT. On multivariable analysis, categories associated with increased likelihood of exhibiting FT included single marital status and not receiving chemotherapy and/or radiation therapy, with an odds ratio (95% CI) of [3.02 (1.07, 8.51), P = 0.037] and [3.86 (1.3, 11.44), P = 0.015) respectively. Higher EWB and SWB scores directly correlated with higher FT scores. Patients undergoing complex GI surgery often experience FT that affects patient-reported outcomes. FT is associated with identifiable preoperative factors that can be utilized to screen patients for interventions that may mitigate some of the harmful effects of FT.