Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2017; 23(16): 2972-2977
Published online Apr 28, 2017. doi: 10.3748/wjg.v23.i16.2972
Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia, Department of General and Digestive Surgery, University Hospital of Guadalajara, 19002 Guadalajara, Spain
Author contributions: Manuel-Vázquez A and Latorre-Fragua R contributed equally to this work; Manuel-Vázquez A, Latorre-Fragua R designed the study, performed the research, analyzed data, wrote the paper; Ramiro-Pérez C analyzed and interpreted of data; López-Marcano A performed the research; Al-Shwely F analyzed and interpreted of data; De la Plaza-Llamas R critically reviewed; Ramia JM critically reviewed, finally approved, supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the University Hospital of Guadalajara, Spain.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alba Manuel-Vázquez, MD, Department of General and Digestive Surgery, University Hospital of Guadalajara, Calle Donante de sangre s/n, 19002 Guadalajara, Spain. alba_manuel_vazquez@hotmail.com
Telephone: +34-949-209200 Fax: +34-949-209218
Received: December 16, 2016
Peer-review started: December 19, 2016
First decision: February 9, 2017
Revised: February 24, 2017
Accepted: March 30, 2017
Article in press: March 30, 2017
Published online: April 28, 2017
Abstract
AIM

To determine the incidence of readmission after cholecystectomy using 90 d as a time limit.

METHODS

We 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.

RESULTS

We 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.

CONCLUSION

The 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.

Keywords: Cholecystectomy, 90-d, Hospital readmission, Readmission rate, Cholelithiasis

Core tip: The use of a 30-d cutoff point to determine the rate of readmissions may underestimate the true incidence of complications. The current tendency is to use 90 d as a time limit to measure complications associated with any surgical procedure. Our objective is to determine the incidence of readmission after cholecystectomy using this longer time limit.