Effect of medical or surgical admission on outcome of patients with gallstone pancreatitis and common bile duct stones
| Autor: | David H. Berger, Yuchiao Chang, Suzanne M. Sokal, Deborah McGrath, Jennifer LaFemina |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Cost-Benefit Analysis Gallstones Patient Readmission Risk Assessment Statistics Nonparametric Coronary artery disease Cohort Studies Patient Admission Postoperative Complications Diabetes mellitus medicine Humans Cholecystectomy Hospital Costs Quality Indicators Health Care Retrospective Studies Cholangiopancreatography Endoscopic Retrograde Common bile duct business.industry General surgery Incidence (epidemiology) Gastroenterology Retrospective cohort study medicine.disease medicine.anatomical_structure Logistic Models Treatment Outcome Pancreatitis Multivariate Analysis Linear Models Surgery Female Risk assessment business Hospital Units Cholangiography Cohort study Follow-Up Studies |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 12(9) |
| ISSN: | 1873-4626 |
| Popis: | Management of uncomplicated common bile duct stone (CBDS) and gallstone pancreatitis (GP) presumably varies based on whether a patient is admitted to medicine or surgery. This study evaluates the impact of admitting team on outcome and cost. Three hundred seventy patients admitted to the Massachusetts General Hospital for CBDS or GP were retrospectively analyzed for demographics, insurance status, procedures, complications, length of stay, readmission, and cost. A multivariable analysis was conducted for outcome and cost measures. Patients admitted to a surgical service were younger than those admitted to a medical service. Gender, race, tobacco use, and the presence of chronic obstructive pulmonary disease and chronic renal insufficiency were not significantly different between groups. Patients admitted to a medical service had a higher incidence of coronary artery disease and diabetes. Despite lower readmission rates for surgical patients, there was no difference in total hospital days between groups. Though total cost of an initial surgical admission was greater than a medical admission, total cost attributable to the index admission diminished over time and ultimately was not significant in follow-up. Despite variations in uncomplicated management of CBDS and GP, there is no difference, in long-term follow-up, in the total number of hospital days or cost for the management of CBDS or GP based on admitting team practices. |
| Databáze: | OpenAIRE |
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