TY - JOUR
T1 - Management of acute mild gallstone pancreatitis under acute care surgery
T2 - Should patients be admitted to the surgery or medicine service?
AU - Kulvatunyou, Narong
AU - Watt, John
AU - Friese, Randall S.
AU - Gries, Lynn
AU - Green, Donald J.
AU - Joseph, Bellal
AU - O'Keeffe, Terence
AU - Tang, Andrew L.
AU - Vercruysse, Gary
AU - Rhee, Peter
N1 - Publisher Copyright:
© 2014 Elsevier Inc.All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs ($11,492 ± 6,480 vs $16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.
AB - Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs ($11,492 ± 6,480 vs $16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.
KW - Gallstone pancreatitis
KW - Medicine service
KW - Surgery service
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U2 - 10.1016/j.amjsurg.2014.09.003
DO - 10.1016/j.amjsurg.2014.09.003
M3 - Article
C2 - 25312841
AN - SCOPUS:84916608398
SN - 0002-9610
VL - 208
SP - 981
EP - 987
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -