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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | Destabilization of strigolactone receptor DWARF14 by binding of ligand and E3-1igase signaling effector DWARF3显示文摘 | Li-Hua Zhao X Edward Zhou Wei Yi Zhongshan Wu Yue Liu Yanyong Kang Li Hou Parker W de Waal Suling Li Yi Jiang Adrian Scaffidi Gavin R Flematti Steven M Smith Vinh Q Lam Patrick R Griffin YonghongWang Jiayang Li Karsten Melcher H Eric Xu | 2015 | Cell Research2015，25，11： | 7 |
| 3 | Inflammation and Alzheimer’s disease显示文摘 | Haruhiko Akiyama Steven Barger Scott Barnum Bonnie Bradt Joachim Bauer Greg M Cole Neil R Cooper Piet Eikelenboom Mark Emmerling Berndt L Fiebich Caleb E Finch Sally Frautschy W.S.T Griffin Harald Hampel Michael Hull Gary Landreth Lih–Fen Lue Robert Mrak | 2000 | Neurobiology of Aging2000，，3： | 2 |
| 4 | Managing soil carbon 显示文摘 | Lal R Griffin M Apt J | 2004 | Science2004，304，5669： | 1 |
| 5 | Gel-free mass spectrometry-based high through- put proteomics:tools for studying biological response of proteins and proteomes 显示文摘 | Roe M R Griffin T J | 2006 | Proteomics2006，6，17： | 1 |
| 6 | The effect oftemperature and aging on a low activation martensitic steel显示文摘 | Griffin R D Dodd R A Kulcinski G L | 1990 | Metallurgical Transactions1990，21，： | 1 |
| 7 | Three-dimensional imaging system显示文摘 | Yee S R Griffin P M | 1994 | Opt Eng1994，33，6： | 1 |
| 8 | Effect of thickness on the transverse thermalconductivity of thin dielectric films显示文摘 | GRIFFIN Jr A J Brotzen F R | 1994 | J Appl Phys1994，75，8： | 1 |
| 9 | Willingness to pay for flood and ecological risk reduction in an urban watershed显示文摘 | Clark D E Novotny V Griffin R | 2001 | Water Science & Technology2001，45，9： | 1 |
| 10 | Managing soil carbon显示文摘 | Lal R Griffin M Apt J | 2004 | Science2004，304，4： | 1 |
| 11 | Peptide mass maps: a highly informative approach to protein identification 显示文摘 | YATES J R SPEICHER S GRIFFIN P R | 1993 | Anal Biochem1993，214，2： | 1 |
| 12 | Toward a theory of organizational creativity显示文摘 | Woodman R W Sawyer J E Griffin R W | 1993 | Academy of Management Review1993，，18： | 1 |
| 13 | The Satisfaction with Life Scale显示文摘 | Diener E Emmons R A Larsen R J Griffin S | 1985 | Journal of personality assessment1985，49，1： | 1 |
| 14 | Effect of disulfide bond- containing protein on rice starch gelatinization and pasting显示文摘 | Hamaker B R Griffin V K | 1993 | Cereal Chem1993，70，4： | 1 |
| 15 | Work and/or fun: Measuring hedonic and utilitarian shopping显示文摘 | Babin B J Darden W R Griffin M | 1994 | Journal of Consumer Research1994，20，4： | 1 |
| 16 | Bioavailability of a silybin-phosphatidylcholine complex in dogs显示文摘 | Filburn CR Kettenacker R Griffin DW | | 0，，： | 1 |
| 17 | COX-2 selective non-steroidal anti-inflammatory drugs and risk of serious coronary heart disease显示文摘 | Wayne A Ray C Michael Stein James R Daugherty Kathi Hall Patrick G Arbogast Marie R Griffin | 2002 | The Lancet2002，，9339： | 1 |
| 18 | Psychological em- powerment and stractural empowerement among nurse practitioners显示文摘 | Stewart J G Menulty R Griffin M T | 2010 | J Am Acad Nurse Praet2010，22，1： | 1 |
| 19 | Salmonella flagellin induces bystander activation of splenic dendritic cells and hinders bacterial replication in vivo显示文摘 | Salazar-Gonzalez R M Srinivasan A Griffin A | 2007 | J Immunol2007，179，9： | 1 |
| 20 | Identification of sites on the human FcεRIα subunit which are involved in binding human and rat IgE显示文摘 | Chizzonite R Griffin M | 1993 | J Bio Chem1993，268，22： | 1 |
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