Utilization and Outcomes of Cholecystostomy and Cholecystectomy in Patients Admitted With Acute Cholecystitis: A Nationwide Analysis
| العنوان: | Utilization and Outcomes of Cholecystostomy and Cholecystectomy in Patients Admitted With Acute Cholecystitis: A Nationwide Analysis |
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| المؤلفون: | David V Strain, Jeffrey Forris Beecham Chick, Resmi A. Charalel, Vibhor Wadhwa, Osman Ahmed, Premal S. Trivedi, Mina S. Makary |
| المصدر: | American Journal of Roentgenology. 216:1558-1565 |
| بيانات النشر: | American Roentgen Ray Society, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Multivariate analysis, Adolescent, medicine.medical_treatment, Cholecystitis, Acute, 030218 nuclear medicine & medical imaging, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Risk of mortality, Acute cholecystitis, Humans, Cholecystectomy, Radiology, Nuclear Medicine and imaging, Cholecystostomy, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Gallbladder, General Medicine, Odds ratio, Middle Aged, medicine.disease, United States, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Cholecystitis, Female, business |
| الوصف: | OBJECTIVE. The purpose of this study was to report national utilization trends and outcomes after percutaneous cholecystostomy, cholecystectomy, or no intervention among patients admitted to hospitals with acute cholecystitis. MATERIALS AND METHODS. The Nationwide Inpatient Sample was queried from 2005 to 2014. Admissions were identified and stratified into treatment groups of percutaneous cholecystostomy, cholecystectomy, and no intervention on the basis of International Classification of Diseases, 9th revision, codes. Outcomes, including length of stay, inpatient mortality, and complications including hemorrhage and bile peritonitis, were identified. Multivariate analysis was performed to identify mortality risk by treatment type after adjustment for baseline comorbidities and risk of mortality. RESULTS. Among 2,550,013 patients (58.6% women, 41.4% men; mean age, 55.9 years) admitted for acute cholecystitis over the study duration, 73,841 (2.9%) patients underwent percutaneous cholecystostomy, 2,005,728 (78.7%) underwent cholecystectomy, and 459,585 (18.0%) did not undergo either procedure. Use of percutaneous cholecystostomy increased from 2985 procedures in 2005 to 12,650 in 2014. The percutaneous cholecystostomy cohort had a higher mean age (70.6 years) than the other two groups (cholecystectomy, 53.8 years; no intervention, 62.5 years), a higher mean comorbidity index (cholecystostomy, 3.74; cholecystectomy, 1.77; no intervention, 2.65), and a higher mean risk of mortality index (cholecystostomy, 2.88; cholecystectomy, 1.45; no intervention, 2.07) (p < .05). Unadjusted inpatient all-cause mortality was 10.1% in the percutaneous cholecystostomy, 0.8% in the cholecystectomy, and 5.2% in the no intervention cohorts. After adjustment for baseline mortality risk, percutaneous cholecystostomy (odds ratio, 0.78; 95% CI, 0.76-0.81) and cholecystectomy (odds ratio, 0.42; 95% CI, 0.41-0.43) were associated with reduced mortality compared with no intervention. CONCLUSION. Use of percutaneous cholecystostomy is increasing among patients admitted with acute cholecystitis. After adjustment for baseline comorbidities, percutaneous cholecystostomy is associated with improved odds of survival compared with no intervention. |
| تدمد: | 1546-3141 0361-803X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9bb4f679a76ba688aec985f920b2aea9 https://doi.org/10.2214/ajr.20.23156 |
| رقم الأكسشن: | edsair.doi.dedup.....9bb4f679a76ba688aec985f920b2aea9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15463141 0361803X |
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