N.N. Mahajan1, G. Romero-Velez2, K. Shapiro1 1Montefiore Medical Center, Surgery, Bronx, NY, USA 2Cleveland Clinic, Endocrine Surgery, Cleveland, OHIO, USA
Introduction: There are approximately 750,000 laparoscopic cholecystectomies performed annually in the Unites States. Of these, at least 280,000 cases are non-elective laparoscopic cholecystectomies (LC). Identifying the factors affecting length of stay (LOS) of non-elective LC is the first step towards the development of standardized care pathways to optimize outcome. This study aims to determine the factors affecting LOS in patients without comorbidities undergoing non-elective LC.
Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent non-elective LC without concomitant procedures from 2010 to 2020 (n=115,142). 55,481 patients without comorbidities, with Body Mass Index (BMI) 18.5-60 and LOS outcome data were included. Prolonged LOS was defined as >2 days. A sensitivity analysis was conducted with prolonged LOS defined as >1 day. All analyses were performed using SAS v9.4.
Results: 15,167 patients (32%) had LOS >2 days and 28, 281 patients (60%) had LOS >1 day. On logistic regression analysis, prolonged LOS was found in 31% of patients with ASA class 1 and 2 versus 44% of patients with ASA class >2 (OR 1.67; 95% CI 1.580-1.761), 33% of patients with independent functional status versus 72% of patients with partially dependent functional status (OR 3.94; 95% CI 2.757-5.626) and 79% of patients with dependent functional status (OR 4.45; 95% CI 2.169-9.117).
Conclusion: This study showed that a significant percentage of patients without comorbidities and with independent functional status undergoing non-elective LC had prolonged LOS, highlighting the need to evaluate non-clinical factors via further institutional studies.