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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 | Autogenous deformatim and change of the relalive humidity in silica fume-modified cement paste显示文摘 | JENSON 0 M HANSEN P F | 1996 | ACI Materials Journal1996，93，6： | 1 |
| 3 | Chemistry and properties of a phenylethynyl-terminated polyimide显示文摘 | Bryant R G Jenson B J Hergenrother P M | 1996 | Journal of Applied Polymer Science1996，59，8： | 1 |
| 4 | But what about Smart girls? adolescent self-esteem and sex role perceptions as a function of academic achievement显示文摘 | ROBINSON-AWANA P KEHLE T J JENSON W R | 1986 | Journal of Educational Psychology1986，78，3： | 1 |
| 5 | But What about Smart Girls? Adolescent Self-esteem and Sex Perception As a Function of Academic Achievement显示文摘 | Robinson-Awana P Kehle J T Jenson W R | 1986 | J Educational Psychology1986，78，3： | 1 |
| 6 | An acceleration damper: develop- ment, design and some application 显示文摘 | LIEBER P JENSON D P | 1945 | Trans ASME1945，67，7： | 1 |
| 7 | Psychiatric morbidity in primary public health care显示文摘 | Fink P Jenson J Borgquist | 1995 | Acta Psychiatry Scand1995，92，： | 1 |
| 8 | But what about smart girls? Adolescent self-esteem and sex perception as a function of academic achievement显示文摘 | Robinson--Awana P Kehle T J Jenson W R | 1986 | Journal of Educational Psychology1986，78，3： | 1 |
| 9 | Evaluation of the effect of smokeless tobacco purified products and extracts on latent Epstein-Barr virus显示文摘 | Jenson H B Heard P Moyer M P | 1999 | Toxicology1999，133，1： | 1 |
| 10 | Dynamic model for vacuum freeze - drying of waterlogged archaeological wooden artifacts显示文摘 | Jenson P Jensen J B | 2006 | J Cult Herit2006，7，： | 1 |
| 11 | A comparison of the effectiveness of intravenous immunoglobulin and plasma exchange as preoperative therapy of myasthenia gravis显示文摘 | Jenson P Bril V | 2008 | J Clin Neuromuscul Dis2008，9，3： | 1 |
| 12 | Cervical cancer:Etiology,pathogenesis,treatment,and future vaccines显示文摘 | Ghim S J Basu P S Jenson A | 2002 | Asian Pac J Cancer Prey2002，3，3： | 1 |
| 13 | Joseph geology and seismic deconvolution显示文摘 | Todoeschuck J P Jenson O G | 1988 | Geophysics1988，53，： | 1 |
| 14 | Overcompensationby plant: Herbivore optimization or redherring显示文摘 | Bleslky A J Carson W P Jenson C L | 1993 | Evolve Ecology1993，12，7： | 1 |
| 15 | Phosphorus cycling in a coastal marine sediment, Aarthus Bay,Denmark 显示文摘 | JENSON H S MORTENSEN P B ANDERSEN F | 1995 | Limnol Oceanogr1995，40，5： | 1 |
| 16 | Fuel nitrogen conversion in solid fuel fired systems 显示文摘 | GLARBORG P JENSON A D JHONSSON J E | 2003 | Progress in Energy and Combustion Science2003，29，2： | 1 |
| 17 | Temperature phased anaerobic digestion increased apparent hydrolysis rate for waste activated sludge显示文摘 | GE Huoqing JENSON P D BESTONE D J | | 0，，： | 1 |
| 18 | Energy transfer in connection with the photo-oxidation of polystyrene and its blends with poly(2,6-dimethyl-1,4-phenylene oxide)显示文摘 | Kops J | 1981 | J Polym Sci1981，19，： | 1 |
| 19 | Precision of the estimation of scatterers size in cancellous bone using spectral backscatter显示文摘 | Padilla F Jenson F Laugier P | 2005 | IEEE Ultrasonics Symposium2005，4，： | 1 |
| 20 | Immunoproylaxis in fish by injection of mouse antibody genes 显示文摘 | Lorenzen N Cupit P M Jenson K E | 2000 | Nature Biotechnol2000，18，： | 1 |
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