Index admission cholecystectomy for acute cholecystitis reduces 30-day readmission rates in pediatric patients

Infographic · Feb 2024 · 1 min read

In brief

National database study of 550 pediatric acute cholecystitis cases found that performing cholecystectomy during index admission reduced 30-day readmission rates from 22.6% to 2.8%. Patients who delayed surgery had over 10-fold higher odds of readmission, supporting early surgical intervention in pediatric cholecystitis.

Index cholecystectomy for acute cholecystitis reduces 30-day readmission from 22.6% to 2.8% in pediatric patients
Delayed cholecystectomy increases readmission odds 10-fold (OR 10.66) compared to index admission surgery
79% of pediatric acute cholecystitis cases underwent index cholecystectomy, leaving 21% at high readmission risk
Female pediatric patients have 3.4-fold higher readmission odds than males after acute cholecystitis
Barriers to index cholecystectomy persist despite clear clinical benefit and society recommendations

Written by the GCMD Library team from the infographic.

The infographic uses a left-to-right flow layout with a red sidebar containing study metadata. The center shows an illustrated patient figure with abdominal pain indicators, followed by icons representing hospital admission and home discharge. The right side displays outcome metrics with downward arrows (3x and 10x) pointing to circular and rectangular icons representing length of stay and readmission rates, with percentages in blue text.

New Infographic By Dr. Jose Campos & the Chilean Society of Pediatric Surgeons

"Index admission cholecystectomy for acute cholecystitis reduces 30-day readmission rates in pediatric patients"

Authors: Sagar J Pathak, Hyun Ji, Amar Nijagal, Patrick Avila, Sun-Chuan Dai, Mustafa A Arain, Abdul Kouanda

Full article: https://gcmd.co/4bOu0Ih

Abstract

Background

Adult patients with cholecystitis who do not undergo cholecystectomy on index admission have worse outcomes, however, there is a paucity of data of the role of cholecystectomy during index hospitalization in the pediatric population. Our aim was to determine outcomes and readmission rates among pediatric patients with cholecystitis who underwent index cholecystectomy versus those who did not.

Methods

We performed a retrospective study of pediatric (< 18 years old) admitted with acute cholecystitis (AC) requiring hospitalization using the 2018 National Readmission Database (NRD). Exclusion criteria included age ≥ 18 years and death on index admission. Multivariable logistic regression was performed to identify factors associated with 30-day readmissions.

Results

We identified 550 unique index acute cholecystitis admissions. Mean age was 14.6 ± 3.0 years. Majority of patients were female (n = 372, 67.6%). Index cholecystectomy was performed in (n = 435, 79.1%) of cases. Thirty-day readmission rate was 2.8% in patients who underwent index cholecystectomy and 22.6% in those who did not (p < 0.001). On multivariable analysis, patients who did not undergo index cholecystectomy had higher odds of 30-day readmission than those who did not (OR 10.66, 95% CI 5.06-22.45, p < 0.001). Female patients also had higher odds of 30-day readmission compared to males (OR 3.37, 95% CI 1.31-8.69).

Conclusions

Patients who did not undergo index cholecystectomy had over tenfold increase in odds of 30-day readmission. Further research is required to understand the barriers to index cholecystectomy despite society recommendations and clear clinical benefit.

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