The Impact of Hospital Level of Care on the Management of Acute Cholecystitis: a Population-Based Study

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Lindqvist, LisaKarolinska Institutet,Umeå universitet,Kirurgi (author)

The Impact of Hospital Level of Care on the Management of Acute Cholecystitis : a Population-Based Study

Article/chapterEnglish2022

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2022-10-17
Springer,2022
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:umu-200434
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-200434URI
https://doi.org/10.1007/s11605-022-05471-1DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:150945722URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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BACKGROUND: The organization of healthcare could have an impact on the outcome of patients treated for acute cholecystitis (AC). The aim of this study was to analyze the way in which patients with AC are managed relative to the level of care by the treating hospital.METHODS: Data were collected from the Swedish Register for Gallstone Surgery and ERCP (GallRiks). Cholecystectomies between 2010 and 2019 were included. The inclusion criterion was acute cholecystectomy in patients with AC operated at either tertiary referral centers (TRCs) or regional hospitals.RESULTS: A total of 24,194 cholecystectomies with AC met the inclusion criterion. The time between admission and acute surgery was significantly elongated at TRCs compared with regional hospitals (2.2 ± 1.7 days vs. 1.6 ± 1.4 days, mean ± SD; p < 0.0001). Patients with a history of AC were more frequent at TRC (10.1% vs. 8.9%, p < 0.0056) and had a higher adverse event rate compared with those at regional hospitals (OR 1.61; CI 1.40-1.84, p < 0.0001). Surprisingly, an increased number of hospital beds correlated slightly with an increased number of days between admission and surgery (R2 = 0.132; p = 0.0075).CONCLUSION: Compared with regional hospitals, patients with AC had to wait longer at TRCs before surgery. A history of AC significantly increased the risk of adverse events. These findings indicate that logistic and organizational aspects of hospital care may affect the management of patients with AC. However, whether these findings can be generalized to healthcare organizations outside Sweden requires further investigation.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Acute cholecystitis
Hospital level of care
National registry
Surgery
Tertiary referral centers

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Andersson, AndreasUmeå universitet,Kirurgi (author)
Österberg, JohannaDepartment of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Department of Surgery, Mora Hospital, Mora, Sweden (author)
Sandblom, GabrielKarolinska Institutet (author)
Hemmingsson, Oskar,1975-Umeå universitet,Kirurgi(Swepub:umu)osrhen96 (author)
Nordin, PärUmeå universitet,Kirurgi(Swepub:umu)pano0023 (author)
Enochsson, LarsUmeå universitet,Kirurgi,Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Department of Surgery, Sunderby Hospital, Luleå, Sweden(Swepub:umu)laen0014 (author)
Umeå universitetKirurgi (creator_code:org_t)

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In:Journal of Gastrointestinal Surgery: Springer26, s. 2551-25581091-255X1873-4626

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