Predicting prolonged hospital stay after laparoscopic cholecystectomy

Morimoto, Yoshikazu; Mizuno, Hitoshi; Akamaru, Yusuke; Yasumasa, Keigo; Noro, Hiroshi; Kono, Emiko; Yamasaki, Yoshio

doi:10.1111/ases.12183

Cited by 18 publications

(20 citation statements)

References 22 publications

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“…Improvements in LC and anesthetic techniques, together with increased familiarity with the procedure lead to progressively shorter hospital stays. 9 In a recent study by Morimoto et al, 4 ASA scores and LC difficulty were the most influential predictive risk factors for a longer hospital stay. In addition, LC in elderly patients is associated with higher complications rates and longer hospital stays.…”

Section: Discussionmentioning

confidence: 90%

“…Operative findings of acute inflammation or postoperative complications did not have any influence on the length of hospital stay. Recently, Morimoto et al 4 reported that the American Society of Anesthesiologists (ASA) score and LC difficulty are the most predictive factors on length of hospital stay. Other studies have proposed advanced age and intraoperative complications as predictive risk factors.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are few published articles on factors influencing the postoperative hospital stay after LC. 3 4 8 This study aimed to identify influencing factors on postoperative hospital stay after LC based on retrospective analysis of data from multiple centers.…”

Section: Introductionmentioning

confidence: 99%

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Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy

Chong

Lee

Yoon

et al. 2016

Korean J Hepatobiliary Pancreat Surg

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Backgrounds/AimsLaparoscopic cholecystectomy can reduce postoperative pain and recovery time. However, some patients experience prolonged postoperative hospital stay. We aimed to identify factors influencing the postoperative hospital stay after laparoscopic cholecystectomy.MethodsPatients (n=336) undergoing laparoscopic cholecystectomy for gallbladder pathology at 8 hospitals were enrolled and divided into 2 groups: 2 or less and more than 2 days postoperative stay. Perioperative factors and patient factors were retrospectively analyzed.ResultsThe patient population median age was 52 years, and consisted of 32 emergency and 304 elective operations. A univariate analysis of perioperative factors revealed significant differences in operation time (p<0.001), perioperative transfusion (p=0.006), emergency operation (p<0.001), acute inflammation (p<0.001), and surgical site infection (p=0.041). A univariate analysis of patient factors revealed significant differences in age (p<0.001), gender (p=0.036), diabetes mellitus (p=0.011), preoperative albumin level (p=0.024), smoking (p=0.010), and American Society of Anesthesiologists score (p=0.003). In a multivariate analysis, operation time (p<0.001), emergency operation (p<0.001), age (p=0.014), and smoking (p=0.022) were identified as independent factors influencing length of postoperative hospital stay.ConclusionsOperation time, emergency operation, patient age, and smoking influenced the postoperative hospital stay and should be the focus of efforts to reduce hospital stay after laparoscopic cholecystectomy.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy

Chong

Lee

Yoon

et al. 2016

Korean J Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

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“…TG severity grading reportedly plays an important role in the outcome of LC [10] and open conversion cholecystectomy is also an important factor [11,12]. The factors affecting the outcome of LC increase postoperative complications, mortality rates, and length of hospital stay, leading to economic losses [13]. Therefore, it was determined whether these identified risk factors directly affected the clinical outcome of the 2 groups of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The data of LC surgery performed by 3 surgeons at the same medical center were collected; however, the experience of each surgeon was not considered. This may have had an influence on the operating time, conversion rate, and clinical outcomes [13]. In addition, the differences in the overall health status and the incidence of accompanying diseases which were age related were not considered.…”

Section: Discussionmentioning

confidence: 99%

Clinical Safety of Laparoscopic Cholecystectomy in Elderly Patients: A Comparison of Clinical Outcomes in Patients Aged 65 to 79 Years and over 80 Years

et al. 2020

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IntroductionThe incidence of acute cholecystitis (AC) increases with age, ranging from 20% to 30% among elderly individuals, and up to 80% among institutionalized elderly patients aged > 90 years. Furthermore, > 90% AC cases are closely associated with cholelithiasis [1]. A previous study has shown that the prevalence of gallstones and AC is correlated with age [2]. The standard treatment of AC is laparoscopic cholecystectomy (LC) in young adults [3]. However, the safety of LC for elderly patients remains controversial owing to them having increased comorbidity risks [4]. Reduced physiologic reserve increases the risk of morbidity and mortality in elderly patients. High rates of morbidity and mortality make it challenging for surgeons to select an optimal operative management strategy [5]. Thus, many clinicians considered percutaneous biliary drainage to avoid administration of general anesthesia and surgery [6]. However, there was no clinical evidence to support this concern. Recently, perioperative care for elderly patients and LC technique has been improved, which reduces the risk associated with LC. The demand of surgery for AC has increased, and thus there is a need to evaluate the clinical safety and efficacy of LC in super-elderly patients (≥ 80 years) compared with elderly patients (≤ 65-79 years).

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The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day‐Case Cholecystectomy Using the CholeS Data Set

2019

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Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Sameday discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15-0.23), higher ASA scores (OR 0.19, 95% CI 0.15-0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58-0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48-0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34-0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of B5 was associated with 80.8% successful daycase cholecystectomy compared with 19.2% associated with a CAAD score [5 (p \ 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy.

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Predicting prolonged hospital stay after laparoscopic cholecystectomy

Abstract: Thirteen factors closely related to hospital stay duration and LOS prediction score could predict the prolongation of a patient's hospital stay.

Cited by 18 publications

References 22 publications

Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy

Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy

Clinical Safety of Laparoscopic Cholecystectomy in Elderly Patients: A Comparison of Clinical Outcomes in Patients Aged 65 to 79 Years and over 80 Years

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day‐Case Cholecystectomy Using the CholeS Data Set

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