318 The Hidden Cost of Infection: The Economic Impact of Infection After Pancreatic Surgery

Abstract Aim UK data examining the cost implications of infection following pancreatic resection are sparse. This study aimed to quantify the financial burden of surgical site infections (SSI), comprising superficial SSI (SSSI) and organ-space SSIs (OSSSI), and hospital acquired pneumonia (HAP) after pancreatic resection. Method A retrospective review of 67 pancreatic resections performed at a single UK centre in 2024 was conducted. Patient-Level Information and Costing Systems data were used to calculate costs and length of stay (LOS). Median values were reported. Mann-Whitney and Fisher’s exact tests identified variables associated with SSI and HAP, which then entered Firth-penalised logistic regression models. Results SSI and/or HAP occurred in 48% of patients. Compared with infection-free patients (median total cost £25,472; LOS 10 days), overall SSI increased cost to £38,440 (+51%, p<0.001) and LOS to 25 days. OSSSI was the most frequent complication (36%) with the greatest relative cost increase (+£14,765, +57%, p<0.001; LOS 25 days). SSSI occurred in 12%, adding £6428 (+22%, p=0.13) and 8 days to LOS. POPF grade B/C was strongly associated with SSI (OR 13.6, 95% CI 3.7–69.3, p<0.001). HAP occurred in 18%, increasing costs to £43,143 (+52%, p<0.01) and LOS to 27 days. Current smoking independently predicted HAP (OR 7.8, 95% CI 1.4–50.7, p=0.02). Conclusions SSI and HAP increase hospital costs by ∼50% and extend LOS by two weeks after pancreatic resection. Strategies such as smoking cessation, optimised antibiotic prophylaxis, and POPF mitigation should be prioritised to reduce complications, lower costs, and promote high value surgical care.