Risk factors for readmission after a cholecystectomy: a case-control study.

Daniel Garcia, Antonia Pastore, Javier Rodriguez, Fernando Crovari, Jaime Cerda, Patricia Rebolledo, Pablo Achurra, Eduardo Viñuela, Jorge Martinez, Martin Dib, Eduardo Briceño
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Abstract

Objective: The aim of this study was to assess the risk factors associated with 30-day hospital readmissions after a cholecystectomy.

Methods: We conducted a case-control study, with data obtained from UC-Christus from Santiago, Chile. All patients who underwent a cholecystectomy between January 2015 and December 2019 were included in the study. We identified all patients readmitted after a cholecystectomy and compared them with a randomized control group. Univariate and multivariate analyses were conducted to identify risk factors.

Results: Of the 4866 cholecystectomies performed between 2015 and 2019, 79 patients presented 30-day hospital readmission after the surgical procedure (1.6%). We identified as risk factors for readmission in the univariate analysis the presence of a solid tumor at the moment of cholecystectomy (OR = 7.58), high pre-operative direct bilirubin (OR = 2.52), high pre-operative alkaline phosphatase (OR = 3.25), emergency admission (OR = 2.04), choledocholithiasis on admission (OR = 4.34), additional surgical procedure during the cholecystectomy (OR = 4.12), and post-operative complications. In the multivariate analysis, the performance of an additional surgical procedure during cholecystectomy was statistically significant (OR = 4.24).

Conclusion: Performing an additional surgical procedure during cholecystectomy was identified as a risk factor associated with 30-day hospital readmission.

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胆囊切除术后再次入院的风险因素:病例对照研究。
研究目的本研究旨在评估与胆囊切除术后 30 天再住院相关的风险因素:我们进行了一项病例对照研究,数据来自智利圣地亚哥的 UC-Christus。所有在2015年1月至2019年12月期间接受胆囊切除术的患者都被纳入研究范围。我们确定了所有胆囊切除术后再次入院的患者,并将他们与随机对照组进行了比较。我们进行了单变量和多变量分析,以确定风险因素:在2015年至2019年期间进行的4866例胆囊切除术中,有79名患者在手术后30天内再次入院(1.6%)。在单变量分析中,我们将以下因素确定为再入院的风险因素:胆囊切除术时存在实体瘤(OR = 7.58)、术前直接胆红素高(OR = 2.52)、术前碱性磷酸酶高(OR = 3.25)、急诊入院(OR = 2.04)、入院时有胆总管结石(OR = 4.34)、胆囊切除术期间有额外的外科手术(OR = 4.12)以及术后并发症。在多变量分析中,胆囊切除术中进行额外手术具有统计学意义(OR = 4.24):结论:在胆囊切除术中进行额外的外科手术被认为是与 30 天再入院相关的风险因素。
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