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J Crohns Colitis. 2013 Jun;7(5):e164-70. doi: 10.1016/j.crohns.2012.07.032. Epub 2012 Sep 6.

Impact of inflammatory bowel disease on post-cholecystectomy complications and hospitalization costs: a Nationwide Inpatient Sample study.

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  • 1Department of Gastroenterology, Digestive Disease Institute, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.

Abstract

BACKGROUND AND AIM:

Our previous single-center study showed that patients with underlying inflammatory bowel disease (IBD) had a higher risk for post-cholecystectomy complications. The aim of the current population-based study was to verify whether concomitant IBD was indeed associated with an increased risk of post-cholecystectomy complications.

METHODS:

In this cross-sectional study, all 1,155,432 patients from the Nationwide Inpatient Sample (NIS) with a primary procedure of cholecystectomy were examined, and 5891 patients with IBD were compared with 1,149,541 patients without IBD from 2006 to 2008.

RESULTS:

There were no significant differences in age, gender, frequency of obesity, and post-operative mortality between the two groups. More patients in the IBD group had post-operative complications than the non-IBD group [398/5891 (6.8%) vs. 55,202/1,149,541 (4.8%), p=0.002)]. On multivariate analysis, the presence of Crohn's disease (CD) was associated with an increased risk for post-operative complications (odds ratio [OR]=1.6; 95% confidence interval [CI], 1.2-2.1, p=0.003). The other risk factors for post-cholecystectomy complications were older age, male gender, African-American race, malnutrition and patients with higher co-morbidity index. The presence of ulcerative colitis (UC) was associated with a trend for increased complications (OR=1.3, 95% CI 0.8-2.1, p=0.08). Patients with IBD who underwent cholecystectomy incurred higher mean hospital costs ($39,651 vs. $35,196, p=0.006) and also stayed in the hospital 1.2 days longer than those without underlying IBD.

CONCLUSIONS:

CD patients undergoing cholecystectomy were shown to have a significantly increased risk for postoperative complications, have a longer stay in the hospital, and incur higher hospitalization costs.

Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

PMID:
22959005
[PubMed - indexed for MEDLINE]
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