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

Authors

Abdullah Sohail, Department of Internal Medicine, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa, IA 52242, United States.
Ahmed Shehadah, Rochester Regional HealthFollow
Ammad Chaudhary, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, United States.
Khadija Naseem, Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195-0001, United States.
Amna Iqbal, Department of Internal Medicine, University of Toledo, Toledo, OH 43606, United States.
Ahmad Khan, Department of Gastroenterology and Hepatology, Case Western Reserve University Hospital, Cleveland, OH 44106, United States.
Shailendra Singh, Division of Gastroenterology and Hepatology, West Virginia University School of Medicine, Morgantown, WV 26505, United States.

Department

Internal Medicine

Document Type

Article

Publication Title

World Journal of Gastrointestinal Endoscopy

Abstract

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% 11.50%). Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attributable 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 readmissions can potentially be prevented by performing same-admission CCY in appropriate patients, which may reduce subsequent hospitalization costs secondary to readmissions.

First Page

350

Last Page

360

DOI

10.4253/wjge.v16.i6.350

Volume

16

Issue

6

Publication Date

6-16-2024

PubMed ID

38946855

Recommended Citation

Sohail, A., Shehadah, A., Chaudhary, A., Naseem, K., Iqbal, A., Khan, A., & Singh, S. (2024). Impact of index admission cholecystectomy vs interval cholecystectomy on readmission rate in acute cholangitis: National Readmission Database survey. World Journal of Gastrointestinal Endoscopy, 16 (6), 350-360. https://doi.org/10.4253/wjge.v16.i6.350