Impact of index admission cholecystectomy vs interval cholecystectomy on readmission rate in acute cholangitis: National Readmission Database survey  

作　　者：Abdullah Sohail Ahmed Shehadah Ammad Chaudhary Khadija Naseem Amna Iqbal Ahmad Khan Shailendra Singh 

机构地区：[1]Department of Internal Medicine,University of Iowa Roy J and Lucille A Carver College of Medicine,Iowa,IA 52242,United States [2]Department of Internal Medicine,Rochester General Hospital,Rochester,NY 14621,United States [3]Department of Internal Medicine,Henry Ford Hospital,Detroit,MI 48202,United States [4]Department of Internal Medicine,Cleveland Clinic Foundation,Cleveland,OH 44195-0001,United States [5]Department of Internal Medicine,University of Toledo,Toledo,OH 43606,United States [6]Department of Gastroenterology and Hepatology,Case Western Reserve University Hospital,Cleveland,OH 44106,United States [7]Division of Gastroenterology and Hepatology,West Virginia University School of Medicine,Morgantown,WV 26505,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第6期350-360,共11页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.

关 键 词：Acute cholangitis Gallstone-related complications National Readmission Database 30-d readmission rates Resource utilization In-hospital mortality 

分 类 号：R614[医药卫生—麻醉学]