Outcomes Following an Index Emergency Admission With Cholecystitis: A National Cohort Study

The objective of this study was to evaluate the differences between patients who undergo cholecystectomy following index admission for cholecystitis, and those who are managed nonoperatively. Summary Background Data: Index emergency cholecystectomy following acute cholecystitis is widely recommended by national guidelines, but its effect on clinical outcomes remains uncertain. Methods: Data collected routinely from the Hospital Episode Statistics database (all admissions to National Health Service organizations in England and Wales) were extracted between April 1, 2002 and March 31, 2015. Analyses were limited to patients aged over 18 years with a primary diagnosis of cholecystitis. Exclusions included records with missing or invalid datasets, patients who had previously undergone a cholecystectomy, patients who had died without a cholecystectomy, and those undergoing cholecystectomy for malignancy, pancreatitis, or choledocholithiasis. Patients were grouped as either “no cholecystectomy” where they had never undergone a cholecystectomy following discharge, or “cholecystectomy.” The latter group was then subdivided as “emergency cholecystectomy” when cholecystectomy was performed during their index emergency admission, or “interval cholecystectomy” when a cholecystectomy was performed within 12 months following a subsequent (emergency or elective) admission. Propensity Score Matching was used to match emergency and interval cholecystectomy groups...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research