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. 2023 Jul 27;23(1):254.
doi: 10.1186/s12876-023-02868-3.

Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations

Suqing Li #  1 , Leonardo Guizzetti #  2 , Christopher Ma  3   2   4 , Abdel Aziz Shaheen  3   4 , Elijah Dixon  5 , Chad Ball  5 , Sachin Wani  6 , Nauzer Forbes  7   8
Affiliations

Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations

Suqing Li et al. BMC Gastroenterol. .

Abstract

Background: Gallstone disease poses a significant health burden in the United States. Choledocholithiasis and cholangitis are common complications of gallstone disease for which data on current epidemiological trends are lacking. We aimed to evaluate temporal changes in hospitalization, management, and outcomes for patients with choledocholithiasis and cholangitis.

Methods: The National Inpatient Sample was used to identify discharges for choledocholithiasis and cholangitis between 2005 and 2014. Temporal trends were evaluated via annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations of interest.

Results: From 189,362 unweighted discharges for choledocholithiasis and/or cholangitis, there was an increase in discharges for choledocholithiasis (APC 2.3%, 95% confidence intervals, CI, 1.9-2.7%) and cholangitis (APC 1.5%, 95% CI 0.7-2.2%). Procedural interventions were more likely at urban hospitals for choledocholithiasis (adjusted odds ratio, aOR, 2.94, 95% CI 2.72 to 3.17) and cholangitis (aOR 2.97, 95% CI 2.50 to 3.54). In-hospital mortality significantly decreased annually for choledocholithiasis (aOR 0.90, 95% CI 0.88 to 0.93) and cholangitis (aOR 0.93, 95% CI 0.89 to 0.97). In-hospital mortality between rural and urban centers was comparable for choledocholithiasis (aOR 1.16, 95% CI 0.89 to 1.52) and cholangitis (aOR 1.12, 95% CI 0.72 to 1.72).

Conclusions: Hospitalizations for choledocholithiasis and cholangitis have increased between 2005 and 2014, reflecting a growing burden of gallstone disease. Hospital mortality between urban and rural centers is similar, however urban centers have a higher rate of procedural interventions suggesting limitations to accessing procedural interventions at rural centers.

Keywords: Cholangitis; Choledocholithiasis; Endoscopic retrograde cholangiopancreatography; Epidemiology; Mortality.

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Conflict of interest statement

The authors declare that they have no competing interests.

The authors declare no competing interests. S. Li, L. Guizzetti, C. Ma, A. Shaheen, E. Dixon, C. Ball, S. Wani, N. Forbes: None Declared.

Figures

Fig. 1
Fig. 1
Temporal change in rates of hospital admissions for Choledocholithiasis (A) and cholangitis (B) per 10,000 hospitalizations with estimated annual percent change and joinpoint regression among all hospital admissions
Fig. 2
Fig. 2
Annual trends in hospital admissions for Choledocholithiasis (A) and cholangitis (B) with estimated annual percent change and joinpoint regression among admissions to rural (left) and urban (right) census division hospitals
See this image and copyright information in PMC

References

    1. Ahmed M. Acute cholangitis - an update. World J Gastrointest Pathophysiol. 2018;9(1):1–7. doi: 10.4291/wjgp.v9.i1.1. - DOI - PMC - PubMed
    1. Buxbaum JL, Abbas Fehmi SM, Sultan S, Fishman DS, Qumseya BJ, Cortessis VK, et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest Endosc. 2019;89(6):1075–105e15. doi: 10.1016/j.gie.2018.10.001. - DOI - PMC - PubMed
    1. Peery AF, Crockett SD, Murphy CC, Jensen ET, Kim HP, Egberg MD, et al. Burden and cost of gastrointestinal, liver, and pancreatic Diseases in the United States: Update 2021. Gastroenterology. 2022;162(2):621–44. doi: 10.1053/j.gastro.2021.10.017. - DOI - PMC - PubMed
    1. Frossard JL, Morel PM. Detection and management of bile duct stones. Gastrointest Endosc. 2010;72(4):808–16. doi: 10.1016/j.gie.2010.06.033. - DOI - PubMed
    1. Neuhaus H, Feussner H, Ungeheuer A, Hoffmann W, Siewert JR, Classen M. Prospective evaluation of the Use of Endoscopic Retrograde Cholangiography prior to laparoscopic cholecystectomy. Endoscopy. 1992;24(09):745–9. doi: 10.1055/s-2007-1010576. - DOI - PubMed

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