Disparities in outpatient rural cholecystectomy outcomes - 10/09/24
, Rie Sakai-Bizmark c, d, e , Krystal Karunungan e , Yongju Pak c , Ramsey Ugarte a , Shannon Richardson e , Daniel A. DeUgarte a, e, f , Steven L. Lee g Abstract |
Background |
Previous studies showed comparable outcomes for common in-patient general surgery operations, but it is unknown if this extends to outpatient operations. Our aim was to compare outpatient cholecystectomy outcomes between rural and urban hospitals.
Methods |
A retrospective cohort analysis was done using the Nationwide Ambulatory Surgery Sample for patients 20-years-and-older undergoing cholecystectomy between 2016 and 2018 at rural and urban hospitals. Survey-weighted multivariable regression analysis was performed with primary outcomes including use-of-laparoscopy, complications, and patient discharge disposition.
Results |
The most common indication for operation was cholecystitis in both hospital settings. On multivariable analysis, rural hospitals were associated with higher transfers to short-term hospitals (adjusted odds ratio [aOR] 2.40, 95%CI 1.61-3.58, p < 0.01) and complications (aOR 1.39, 95%CI 1.11-1.75, p < 0.01). No difference was detected with laparoscopy (aOR 1.93, 95%CI 0.73-5.13, p = 0.19), routine discharge (aOR 1.50, 95%C I0.91-2.45, p = 0.11), or mortality (aOR 3.23, 95%CI 0.10–100.0, p = 0.51).
Conclusions |
Patients cared for at rural hospitals were more likely to be transferred to short-term hospitals and have higher complications. No differences were detected in laparoscopy, routine discharge or mortality.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Rural hospital patients had lower median household income and fewer comorbidities. |
• | Cholecystitis was the most common operative indication in both hospital settings. |
• | Although low, higher complication rates were noted at rural hospitals (0.4 % v 0.3 %). |
• | Rural hospitals are associated with higher transfer rates to short term hospitals. |
• | No difference in laparoscopy, routine discharges or mortality. |
Keywords : Rural, Laparoscopic cholecystectomy, Elective, Outcomes
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Vol 236
Article 115852- octobre 2024 Retour au numéro
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