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Comparative Study
. 2024 Oct:236:115852.
doi: 10.1016/j.amjsurg.2024.115852. Epub 2024 Jul 20.

Disparities in outpatient rural cholecystectomy outcomes

Erin C Howell  1 , Rie Sakai-Bizmark  2 , Krystal Karunungan  3 , Yongju Pak  4 , Ramsey Ugarte  5 , Shannon Richardson  6 , Daniel A DeUgarte  7 , Steven L Lee  8
Affiliations
Comparative Study

Disparities in outpatient rural cholecystectomy outcomes

Erin C Howell et al. Am J Surg. 2024 Oct.

Abstract

Background: Previous studies showed comparable outcomes for common in-patient general surgery operations, but it is unknown if this extends to outpatient operations. Our aim was to compare outpatient cholecystectomy outcomes between rural and urban hospitals.

Methods: A retrospective cohort analysis was done using the Nationwide Ambulatory Surgery Sample for patients 20-years-and-older undergoing cholecystectomy between 2016 and 2018 ​at rural and urban hospitals. Survey-weighted multivariable regression analysis was performed with primary outcomes including use-of-laparoscopy, complications, and patient discharge disposition.

Results: The most common indication for operation was cholecystitis in both hospital settings. On multivariable analysis, rural hospitals were associated with higher transfers to short-term hospitals (adjusted odds ratio [aOR] 2.40, 95%CI 1.61-3.58, p ​< ​0.01) and complications (aOR 1.39, 95%CI 1.11-1.75, p ​< ​0.01). No difference was detected with laparoscopy (aOR 1.93, 95%CI 0.73-5.13, p ​= ​0.19), routine discharge (aOR 1.50, 95%C I0.91-2.45, p ​= ​0.11), or mortality (aOR 3.23, 95%CI 0.10-100.0, p ​= ​0.51).

Conclusions: Patients cared for at rural hospitals were more likely to be transferred to short-term hospitals and have higher complications. No differences were detected in laparoscopy, routine discharge or mortality.

Keywords: Elective; Laparoscopic cholecystectomy; Outcomes; Rural.

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Conflict of interest statement

Declaration of Competing interest We are pleased to submit our original article entitled “Disparities in Outpatient Rural Cholecystectomy Outcomes” for consideration for publication in The American Journal of Surgery. The work included in this submission is our original work. It has not been previously published and is not under consideration for publication elsewhere. Its publication is approved by all authors, who deny any conflicts of interest. If accepted for publication, it will not be published elsewhere in the same form, in English or in any other language, including electronically without written consent of the copyright holder.

References

    1. Sarap MD. Strategies to Improve the Rural Surgical Workforce. Am Surg. 2022;88(9):2132–2135. doi: 10.1177/00031348221091964 - DOI - PubMed
    1. Nakayama DK, Hughes TG. Issues that face rural surgery in the United States. J Am Coll Surg. 2014;219(4):814–818. doi: 10.1016/j.jamcollsurg.2014.03.056 - DOI - PubMed
    1. Kent KC, Foley EF, Golden RN. Rural Surgery--A Crisis in Wisconsin. WMJ. 2015;114(2):81–82. - PubMed
    1. Liu JJ, Bellamy GR, McCormick M. Patient bypass behavior and critical access hospitals: implications for patient retention. J Rural Health. 2007;23(1):17–24. doi: 10.1111/j.1748-0361.2006.00063.x - DOI - PubMed
    1. Zhang Y, Malone TL, Scales CD, Pink GH. Predictors of hospital bypass for rural residents seeking common elective surgery. Surgery. 2023;173(2):270–277. doi: 10.1016/j.surg.2022.06.009 - DOI - PubMed

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