Evidence map›Paper›PMID 34159465›Full record

ArticleSurgical endoscopy2022

Early unplanned readmissions following same-admission cholecystectomy for acute biliary pancreatitis.

Brandon K Chu, Bipul Gnyawali, Jordan M Cloyd, Phil A Hart, Georgios I Papachristou, Luis F Lara, Jeffrey R Groce, Alice Hinton, Darwin L Conwell, Somashekar G Krishna

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Brandon K ChuDepartment of Internal Medicine, The Ohio State University Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA.
Bipul GnyawaliThe Ohio State University College of Medicine, Columbus, OH, USA.
Jordan M CloydDivision of Surgical Oncology, The Ohio State University Wexner Medical Center, James Cancer Center and Solove Research Institute, Columbus, OH, USA.
Phil A HartSection of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA.
Georgios I PapachristouSection of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA.
Luis F LaraSection of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA.
Jeffrey R GroceSection of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA.
Alice HintonDivision of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA.
Darwin L ConwellSection of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA.
Somashekar G KrishnaSection of Pancreatic Disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA. somashekar.krishna@osumc.edu.ORCID 0000-0001-5748-7890
The Ohio State University Wexner Medical Center · USThe Ohio State University · USThe Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSame-admission cholecystectomy (CCY) is recommended for mild acute biliary pancreatitis (biliary-AP). However, there is a paucity of research investigating reasons for early (30-day) unplanned readmissions in patients who undergo CCY for biliary-AP. Hence, we sought to investigate this gap using a large population database.

methodsUsing the Nationwide Readmission Database (2010-2014), we identified all adults (age ≥ 18 years) with a principal diagnosis of biliary-AP who had undergone CCY during the index hospitalization. Multivariable logistic regression models were obtained to assess independent predictors for 30-day readmission. Principal diagnosis for all readmissions was collected to ascertain the indications for early readmission.

resultsDuring the study period, 118,224 patients underwent same-admission CCY for biliary-AP. Three-fourths of all patients underwent invasive cholangiography during the hospitalization (intraoperative cholangiogram (IOC) = 57,038, ERCP = 31,500). The rate of early (30-day) readmission was 7.25% (n = 8574). Exacerbation of prior medical conditions (42.2%), sequelae of biliary-AP (resolving and recurrent pancreatitis, pseudocysts) (27.6%), surgical site and other postoperative complications (16%), choledocholithiasis and/or bile leak (9.6%), and preventable hospital-acquired conditions (4.6%) accounted for early readmissions. On multivariable analysis, predictors for readmission included male sex (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.08-1.28), insurance type (Medicare insurance [OR 1.26, 95% CI 1.13-1.40]; Medicaid [OR 1.22, 95% CI 1.09-1.38]), outside-facility discharge (OR 1.35, 95% CI 1.16-1.57), severe AP (OR 1.35, 95% CI 1.21-1.50), and ≥ 3 Elixhauser comorbidities (OR 1.55, 95% CI 1.41-1.69). Performance of IOC (OR 0.90, 95% CI 0.82-0.97) and ERCP (OR 0.81, 95% CI 0.73-0.89) were associated with decreased risk of early readmission.

conclusionIn this study, using a national population database evaluating patients who underwent same-admission CCY after biliary-AP, we identified potentially modifiable risk factors and causes for early readmission as well as opportunities to improve clinical care.

Indexed as

PancreatitisPatient ReadmissionAdolescentAdultAgedCholecystectomyHospitalizationHumansMaleMedicareRetrospective StudiesUnited StatesCholecystectomyEarly ReadmissionERCPGallstone PancreatitisIntraoperative cholangiogram

Identifiers

PMID34159465
OpenAlexW3174223990

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.