Age-related differences pre-, intra-, and postcholecystectomy: A retrospective cohort study of 6,868 patients
Cholecystectomy (CCY) is increasingly performed in older individuals. We sought to examine age-related differences in pre-, intra-, and postoperative factors at a community hospital, using a very large, single-institution cholecystectomy database. A retrospective review of 6868 patients who underwen...
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| Veröffentlicht in: | International journal of surgery (London, England) England), 2017-03, Vol.39, p.119-126 |
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| creator | Maqsood, Hadia Patel, Kalpesh Ferdosi, Hamid Sill, Anne M. Wu, Bin Buddensick, Thomas Sautter, Amanda Shaukat, Haroon Sulkowski, Gisela Narducci, Dusty Marie Siddique, Mustafa Kamangar, Farin Kowdley, Gopal C. Cunningham, Steven C. |
| description | Cholecystectomy (CCY) is increasingly performed in older individuals. We sought to examine age-related differences in pre-, intra-, and postoperative factors at a community hospital, using a very large, single-institution cholecystectomy database.
A retrospective review of 6868 patients who underwent CCY from 2001 to 2013 was performed. ROC analysis identified the optimal age cutoff when complications reached a significant inflection point ( |
| doi_str_mv | 10.1016/j.ijsu.2017.01.046 |
| format | Article |
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A retrospective review of 6868 patients who underwent CCY from 2001 to 2013 was performed. ROC analysis identified the optimal age cutoff when complications reached a significant inflection point (<55 and ≥55 years). Multiple clinical features and outcomes were measured and compared by age. Logistic regression was used to examine how well a set of covariates predicted postoperative complications.
Older patients had significantly higher rates of comorbidities and underwent more extensive preoperative imaging. Intraoperatively, older patients had more blood loss, longer operative times, and more open operations. Postoperatively, older patients experienced more complications and had significantly different pathological findings. While holding age and gender constant, regression analyses showed that preoperative creatinine level, blood loss and history of previous operation were the strongest predictors of complications. The risk for developing complications increased by 2% per year of life.
Older patients have distinct pre-, intra-, and postoperative characteristics. Their care is more imaging- and cost-intensive. CCY in this population is associated with higher risks, likely due to a combination of comorbidities and age-related worsened physiological status. Pathologic findings are significantly different relative to younger patients. While removing the effect of age, preoperative creatinine levels, blood loss, and history of previous operation predict postoperative complications. Quantifying these differences may help to inform management decisions for older patients.
•Older patients undergoing cholecystectomy (CCY) have distinct perioperative characteristics compared with younger patients.•Among older patients, preoperative testing, blood loss, operative times and complications are greater.•The risk for developing complications increased by 2% per year of life.</description><identifier>ISSN: 1743-9191</identifier><identifier>EISSN: 1743-9159</identifier><identifier>DOI: 10.1016/j.ijsu.2017.01.046</identifier><identifier>PMID: 28104466</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adenomyosis ; Adult ; Age ; Age Factors ; Aged ; Cholecystectomy ; Cholecystectomy - adverse effects ; Cholecystectomy - statistics & numerical data ; Cholesterolosis ; Comorbidity ; Complications ; Databases, Factual ; Elderly ; Female ; Humans ; Intraoperative Complications - epidemiology ; Intraoperative Complications - etiology ; Logistic Models ; Male ; Middle Aged ; Operative Time ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Period ; Retrospective Studies ; ROC Curve ; Young</subject><ispartof>International journal of surgery (London, England), 2017-03, Vol.39, p.119-126</ispartof><rights>2017 IJS Publishing Group Ltd</rights><rights>Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-c119782164eb8241d597091de0ff85655050f495b9b01d35327479435ffe69d3</citedby><cites>FETCH-LOGICAL-c356t-c119782164eb8241d597091de0ff85655050f495b9b01d35327479435ffe69d3</cites><orcidid>0000-0001-7758-7717</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijsu.2017.01.046$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28104466$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maqsood, Hadia</creatorcontrib><creatorcontrib>Patel, Kalpesh</creatorcontrib><creatorcontrib>Ferdosi, Hamid</creatorcontrib><creatorcontrib>Sill, Anne M.</creatorcontrib><creatorcontrib>Wu, Bin</creatorcontrib><creatorcontrib>Buddensick, Thomas</creatorcontrib><creatorcontrib>Sautter, Amanda</creatorcontrib><creatorcontrib>Shaukat, Haroon</creatorcontrib><creatorcontrib>Sulkowski, Gisela</creatorcontrib><creatorcontrib>Narducci, Dusty Marie</creatorcontrib><creatorcontrib>Siddique, Mustafa</creatorcontrib><creatorcontrib>Kamangar, Farin</creatorcontrib><creatorcontrib>Kowdley, Gopal C.</creatorcontrib><creatorcontrib>Cunningham, Steven C.</creatorcontrib><title>Age-related differences pre-, intra-, and postcholecystectomy: A retrospective cohort study of 6,868 patients</title><title>International journal of surgery (London, England)</title><addtitle>Int J Surg</addtitle><description>Cholecystectomy (CCY) is increasingly performed in older individuals. We sought to examine age-related differences in pre-, intra-, and postoperative factors at a community hospital, using a very large, single-institution cholecystectomy database.
A retrospective review of 6868 patients who underwent CCY from 2001 to 2013 was performed. ROC analysis identified the optimal age cutoff when complications reached a significant inflection point (<55 and ≥55 years). Multiple clinical features and outcomes were measured and compared by age. Logistic regression was used to examine how well a set of covariates predicted postoperative complications.
Older patients had significantly higher rates of comorbidities and underwent more extensive preoperative imaging. Intraoperatively, older patients had more blood loss, longer operative times, and more open operations. Postoperatively, older patients experienced more complications and had significantly different pathological findings. While holding age and gender constant, regression analyses showed that preoperative creatinine level, blood loss and history of previous operation were the strongest predictors of complications. The risk for developing complications increased by 2% per year of life.
Older patients have distinct pre-, intra-, and postoperative characteristics. Their care is more imaging- and cost-intensive. CCY in this population is associated with higher risks, likely due to a combination of comorbidities and age-related worsened physiological status. Pathologic findings are significantly different relative to younger patients. While removing the effect of age, preoperative creatinine levels, blood loss, and history of previous operation predict postoperative complications. Quantifying these differences may help to inform management decisions for older patients.
•Older patients undergoing cholecystectomy (CCY) have distinct perioperative characteristics compared with younger patients.•Among older patients, preoperative testing, blood loss, operative times and complications are greater.•The risk for developing complications increased by 2% per year of life.</description><subject>Adenomyosis</subject><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Cholecystectomy</subject><subject>Cholecystectomy - adverse effects</subject><subject>Cholecystectomy - statistics & numerical data</subject><subject>Cholesterolosis</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Databases, Factual</subject><subject>Elderly</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Complications - epidemiology</subject><subject>Intraoperative Complications - etiology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Period</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Young</subject><issn>1743-9191</issn><issn>1743-9159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9v1DAQxSMEon_gC3BAPnJowkxiOzbisqqgIFXi0ruVtSfUqyQOtlNpvz1ebemR04xG7z3N-1XVB4QGAeXnQ-MPaWtawL4BbIDLV9Ul9ryrNQr9-mXXeFFdpXQA4KBQva0uWoXAuZSX1bz7TXWkacjkmPPjSJEWS4mtkeob5pcchzKHxbE1pGwfw0T2mDLZHObjF7ZjkXIMaS0H_0TMhscQM0t5c0cWRiZvlFRsHbKnJad31ZtxmBK9f57X1cP3bw-3P-r7X3c_b3f3te2EzLVF1L1qUXLaq5ajE7oHjY5gHJWQQoCAkWux13tA14mu7XmveSfK-1K77rr6dI5dY_izUcpm9snSNA0LhS0ZVBKFgr6DIm3PUltKpEijWaOfh3g0COZE2RzMibI5UTaAplAupo_P-dt-Jvdi-Ye1CL6eBVRKPnmKJll_4up8LKCMC_5_-X8B1DiNEw</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Maqsood, Hadia</creator><creator>Patel, Kalpesh</creator><creator>Ferdosi, Hamid</creator><creator>Sill, Anne M.</creator><creator>Wu, Bin</creator><creator>Buddensick, Thomas</creator><creator>Sautter, Amanda</creator><creator>Shaukat, Haroon</creator><creator>Sulkowski, Gisela</creator><creator>Narducci, Dusty Marie</creator><creator>Siddique, Mustafa</creator><creator>Kamangar, Farin</creator><creator>Kowdley, Gopal C.</creator><creator>Cunningham, Steven C.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7758-7717</orcidid></search><sort><creationdate>201703</creationdate><title>Age-related differences pre-, intra-, and postcholecystectomy: A retrospective cohort study of 6,868 patients</title><author>Maqsood, Hadia ; Patel, Kalpesh ; Ferdosi, Hamid ; Sill, Anne M. ; Wu, Bin ; Buddensick, Thomas ; Sautter, Amanda ; Shaukat, Haroon ; Sulkowski, Gisela ; Narducci, Dusty Marie ; Siddique, Mustafa ; Kamangar, Farin ; Kowdley, Gopal C. ; Cunningham, Steven C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-c119782164eb8241d597091de0ff85655050f495b9b01d35327479435ffe69d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenomyosis</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Cholecystectomy</topic><topic>Cholecystectomy - adverse effects</topic><topic>Cholecystectomy - statistics & numerical data</topic><topic>Cholesterolosis</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Databases, Factual</topic><topic>Elderly</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Complications - epidemiology</topic><topic>Intraoperative Complications - etiology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Period</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Young</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maqsood, Hadia</creatorcontrib><creatorcontrib>Patel, Kalpesh</creatorcontrib><creatorcontrib>Ferdosi, Hamid</creatorcontrib><creatorcontrib>Sill, Anne M.</creatorcontrib><creatorcontrib>Wu, Bin</creatorcontrib><creatorcontrib>Buddensick, Thomas</creatorcontrib><creatorcontrib>Sautter, Amanda</creatorcontrib><creatorcontrib>Shaukat, Haroon</creatorcontrib><creatorcontrib>Sulkowski, Gisela</creatorcontrib><creatorcontrib>Narducci, Dusty Marie</creatorcontrib><creatorcontrib>Siddique, Mustafa</creatorcontrib><creatorcontrib>Kamangar, Farin</creatorcontrib><creatorcontrib>Kowdley, Gopal C.</creatorcontrib><creatorcontrib>Cunningham, Steven C.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of surgery (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maqsood, Hadia</au><au>Patel, Kalpesh</au><au>Ferdosi, Hamid</au><au>Sill, Anne M.</au><au>Wu, Bin</au><au>Buddensick, Thomas</au><au>Sautter, Amanda</au><au>Shaukat, Haroon</au><au>Sulkowski, Gisela</au><au>Narducci, Dusty Marie</au><au>Siddique, Mustafa</au><au>Kamangar, Farin</au><au>Kowdley, Gopal C.</au><au>Cunningham, Steven C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-related differences pre-, intra-, and postcholecystectomy: A retrospective cohort study of 6,868 patients</atitle><jtitle>International journal of surgery (London, England)</jtitle><addtitle>Int J Surg</addtitle><date>2017-03</date><risdate>2017</risdate><volume>39</volume><spage>119</spage><epage>126</epage><pages>119-126</pages><issn>1743-9191</issn><eissn>1743-9159</eissn><abstract>Cholecystectomy (CCY) is increasingly performed in older individuals. We sought to examine age-related differences in pre-, intra-, and postoperative factors at a community hospital, using a very large, single-institution cholecystectomy database.
A retrospective review of 6868 patients who underwent CCY from 2001 to 2013 was performed. ROC analysis identified the optimal age cutoff when complications reached a significant inflection point (<55 and ≥55 years). Multiple clinical features and outcomes were measured and compared by age. Logistic regression was used to examine how well a set of covariates predicted postoperative complications.
Older patients had significantly higher rates of comorbidities and underwent more extensive preoperative imaging. Intraoperatively, older patients had more blood loss, longer operative times, and more open operations. Postoperatively, older patients experienced more complications and had significantly different pathological findings. While holding age and gender constant, regression analyses showed that preoperative creatinine level, blood loss and history of previous operation were the strongest predictors of complications. The risk for developing complications increased by 2% per year of life.
Older patients have distinct pre-, intra-, and postoperative characteristics. Their care is more imaging- and cost-intensive. CCY in this population is associated with higher risks, likely due to a combination of comorbidities and age-related worsened physiological status. Pathologic findings are significantly different relative to younger patients. While removing the effect of age, preoperative creatinine levels, blood loss, and history of previous operation predict postoperative complications. Quantifying these differences may help to inform management decisions for older patients.
•Older patients undergoing cholecystectomy (CCY) have distinct perioperative characteristics compared with younger patients.•Among older patients, preoperative testing, blood loss, operative times and complications are greater.•The risk for developing complications increased by 2% per year of life.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28104466</pmid><doi>10.1016/j.ijsu.2017.01.046</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7758-7717</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adenomyosis Adult Age Age Factors Aged Cholecystectomy Cholecystectomy - adverse effects Cholecystectomy - statistics & numerical data Cholesterolosis Comorbidity Complications Databases, Factual Elderly Female Humans Intraoperative Complications - epidemiology Intraoperative Complications - etiology Logistic Models Male Middle Aged Operative Time Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Period Retrospective Studies ROC Curve Young |
| title | Age-related differences pre-, intra-, and postcholecystectomy: A retrospective cohort study of 6,868 patients |
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