Thirty-day readmissions after inpatient laparoscopic cholecystectomy: factors and outcomes

Rana, Gurteshwar; Bhullar, Jasneet Singh; Subhas, Gokulakkrishna; Kolachalam, Ramachandra; Mittal, Vijay K.

doi:10.1016/j.amjsurg.2015.12.007

Cited by 25 publications

(19 citation statements)

References 8 publications

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“…To define readmissions period, some authors use a 30-day period after the index hospital admission discharge, the others a 90-day period [86,91,92]. We think that the 90-day post-index hospital stay readmission period is more meaningful, because it is more likely to capture an adverse event due to a retained CBD stone rather than a 30-day period.…”

Section: Outcomes and Quality Indicators In Laparoscopic Cholecystectomymentioning

confidence: 99%

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Beliaev¹,

Booth²

2016

Actual Problems of Emergency Abdominal Surgery

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Background: Laparoscopic cholecystectomy is the preferred surgical operation for symptomatic gallstone disease. Conversion of laparoscopic cholecystectomy to open surgery is used to prevent intra-abdominal organ injury, for open common bile duct exploration and to repair intra-abdominal organ injury. Objective:The objective of this chapter is to review risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery, and surgical quality outcome measures. Methods:A narrative literature review using Pubmed, Medline, Cochrane library databases and Google search engine is described.Results: From the literature review, patient-and surgeon-related risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery were identified. Patient-dependent risk factors included preoperative and intraoperative variables. Current conversion of laparoscopic cholecystectomy to open surgery predictive models use only patient-dependent risk factors and were not tested on an independent sample of patients. Surgical quality outcome measures incorporate an association between conversion and intra-abdominal organ injury that demonstrates that conversion was used as an emergency strategy to repair injuries rather than a safety measure. Conclusion:Conversion of laparoscopic cholecystectomy to open surgery risk stratification based on patient-and surgeon-dependent variables may allow a better management of the patient to keep conversion at low rates and to maintain benefits of minimally invasive surgery.

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Section: Outcomes and Quality Indicators In Laparoscopic Cholecystectomymentioning

confidence: 99%

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Beliaev¹,

Booth²

2016

Actual Problems of Emergency Abdominal Surgery

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“…In one of the few articles published in the literature, Rana et al[13] analyzed re-hospitalizations at 30 d after laparoscopic procedures and found an overall readmission rate of 5.9%. Surgical reasons (54.4%) were the most frequent cause, and 50% of re-hospitalizations occurred in the first week.…”

Section: Discussionmentioning

confidence: 99%

“…Rana et al[13] reported the following rates for readmission according to cause: surgical-biliary in 22.7% of cases, surgical non-biliary in 31.8%, and non-surgical in 45.4%. In our series, following the same classification, 23.94% of readmissions were for surgical-biliary reasons, 46.48% for surgical non-biliary reasons, and 29.58% for non-surgical reasons.…”

Section: Discussionmentioning

confidence: 99%

“…The following data were recorded: age, sex, ASA classification, biliary disease prior to the intervention, data related to the admission in which the cholecystectomy was performed, days from initial discharge to re-hospitalization, and reason for re-hospitalization, defined as surgical-biliary, surgical non-biliary and non-surgical following Rana et al[13]’s classification.…”

Section: Methodsmentioning

confidence: 99%

“…The study of the reasons for re-hospitalization may help to characterize the postoperative morbidity and costs associated with cholecystectomy, and may provide relevant data for both physicians and hospital managers[6-11]. However, few studies have evaluated the reasons for, or the rate of, readmission after cholecystectomy, and those that have done so have tended to consider the first 30 d post-surgery as the time limit[8,12,13]. This restriction may have led to an underestimation of the actual incidence of morbidity and of the socio-economic cost of the procedure[14].…”

Section: Introductionmentioning

confidence: 99%

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Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis

Manuel-Vázquez¹,

Latorre-Fragua²,

Ramiro-Pérez³

et al. 2017

WJG

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AIMTo determine the incidence of readmission after cholecystectomy using 90 d as a time limit.METHODSWe retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications. We excluded ambulatory cholecystectomy, cholecystectomy combined with other procedures, oncologic disease active at the time of cholecystectomy, finding of malignancy in the resection specimen, and scheduled re-admissions for other unrelated pathologies.RESULTSWe analyzed 1423 patients. There were 71 readmissions in the 90 d after discharge, with a readmission rate of 4.99%. Sixty-four point seven nine percent occurred after elective surgery (cholelithiasis or vesicular polyps) and 35.21% after emergency surgery (acute cholecystitis or acute pancreatitis). Surgical non-biliary causes were the most frequent reasons for readmission, representing 46.48%; among them, intra-abdominal abscesses were the most common. In second place were non-surgical reasons, at 29.58%, and finally, surgical biliary reasons, at 23.94%. Regarding time for readmission, almost 50% of patients were readmitted in the first week and most second readmissions occurred during the second month. Redefining the readmissions rate to 90 d resulted in an increase in re-hospitalization, from 3.51% at 30 d to 4.99% at 90 d.CONCLUSIONThe use of 30-d cutoff point may underestimate the incidence of complications. The current tendency is to use 90 d as a limit to measure complications associated with any surgical procedure.

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Risk factors for 30-day readmission and indication for ERCP following laparoscopic cholecystectomy: a retrospective NSQIP cohort study

Zhou

Vithiananthan

2020

Surg Endosc

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Thirty-day readmissions after inpatient laparoscopic cholecystectomy: factors and outcomes

Cited by 25 publications

References 8 publications

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis

Risk factors for 30-day readmission and indication for ERCP following laparoscopic cholecystectomy: a retrospective NSQIP cohort study

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