Abstract
Background Laparoscopic cholecystectomy is the standard
treatment for symptomatic gallstones. The quality of
the procedure frequently is included in quality improvement
programs, but outcome values have not been described
to define the standard of care for a general population.
This study included 20,307 cholecystectomies from a
national prospective database that combines administrative
data with clinical data. This report states the quality of
cholecystectomy in Denmark, establishes benchmarks, and
identifies significant risk factors.
Methods The Danish Cholecystectomy Database was
queried for data from 2006 to 2009. The outcome measures
included conversion rate, hospital length of stay (LOS),
readmission, additional procedures, and 30-day mortality.
Patient characteristics and operative findings were analyzed
as risk factors using stepwise backward logistic
regression.
Results The study included 20,307 patients (82% of all
cholecystectomies). The conversion rate was 7.6%. Male
sex, acute cholecystitis, and previous upper abdominal
surgery were risk factors for conversion, with respective
odds ratios of 1.50, 4.61, and 3.54. The mean LOS was 1.5
days, and 37.3% of the patients had same-day surgery. The
readmission rate was 9.6%. Nearly 70% had a LOS of 1
day or less and no readmission; 17.3% had a LOS longer
than 3 days and/or readmission; 5.6% had an additional
procedure within 30 days; and 0.2% had a bile duct injury
requiring reconstructive surgery. The 30-day mortality rate
was 0.27%. Age older than 60 years, American Society of
Anesthesiology (ASA) score exceeding 1, and open procedure
were significant risk factors for all the outcomes.
Body mass index (BMI) was not a risk factor for any of the
outcomes.
Conclusion The quality of cholecystectomy is high in
Denmark, with a low conversion rate and a high frequency
of short admissions without readmission. Acute cholecystitis
and open procedure are important risk factors for
poorer outcomes.The results of this study analyzing a large,
unbiased population can be used to benchmark outcomes of
cholecystectomy.
treatment for symptomatic gallstones. The quality of
the procedure frequently is included in quality improvement
programs, but outcome values have not been described
to define the standard of care for a general population.
This study included 20,307 cholecystectomies from a
national prospective database that combines administrative
data with clinical data. This report states the quality of
cholecystectomy in Denmark, establishes benchmarks, and
identifies significant risk factors.
Methods The Danish Cholecystectomy Database was
queried for data from 2006 to 2009. The outcome measures
included conversion rate, hospital length of stay (LOS),
readmission, additional procedures, and 30-day mortality.
Patient characteristics and operative findings were analyzed
as risk factors using stepwise backward logistic
regression.
Results The study included 20,307 patients (82% of all
cholecystectomies). The conversion rate was 7.6%. Male
sex, acute cholecystitis, and previous upper abdominal
surgery were risk factors for conversion, with respective
odds ratios of 1.50, 4.61, and 3.54. The mean LOS was 1.5
days, and 37.3% of the patients had same-day surgery. The
readmission rate was 9.6%. Nearly 70% had a LOS of 1
day or less and no readmission; 17.3% had a LOS longer
than 3 days and/or readmission; 5.6% had an additional
procedure within 30 days; and 0.2% had a bile duct injury
requiring reconstructive surgery. The 30-day mortality rate
was 0.27%. Age older than 60 years, American Society of
Anesthesiology (ASA) score exceeding 1, and open procedure
were significant risk factors for all the outcomes.
Body mass index (BMI) was not a risk factor for any of the
outcomes.
Conclusion The quality of cholecystectomy is high in
Denmark, with a low conversion rate and a high frequency
of short admissions without readmission. Acute cholecystitis
and open procedure are important risk factors for
poorer outcomes.The results of this study analyzing a large,
unbiased population can be used to benchmark outcomes of
cholecystectomy.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Surgical Endoscopy |
| Vol/bind | 25 |
| Udgave nummer | 5 |
| Sider (fra-til) | 1630-41 |
| Antal sider | 12 |
| ISSN | 0930-2794 |
| DOI | |
| Status | Udgivet - 1 maj 2011 |