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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | A capa- city fade model for lithium-ion batteries including diffusion and kinetics显示文摘 | S KRISHNAMURTHY B | 2012 | Eleetrochimica Acta2012，70，： | 1 |
| 3 | Responses against islet antigens in NOD mice are prevented by tolerance to proinsulin but not IGRP显示文摘 | KRISHNAMURTHY B DUDEN N L MCKENZIE M D | 2006 | J Clin Invest2006，116，： | 1 |
| 4 | A short walk in the Blogistan显示文摘 | Cohen E Krishnamurthy B | 2006 | Computer Networks2006，，50： | 1 |
| 5 | Prediction of rotor position at standstill and rotating shaft conditions in switched reluctance machines显示文摘 | Krishnamurthy M Edrington C C Fahimi B | 2006 | IEEE Transactions on Power Electronics2006，21，1： | 1 |
| 6 | Designing leakage tolerant, low power wide-OR dominos for sub-130nm CMO6 technologies 显示文摘 | CHATTERJEE B SACHDEV M KRISHNAMURTHY R | 2005 | Microelectronics Journal2005，36，6： | 1 |
| 7 | A capacity fade model for lithium-ion batteries including diffusion and kinetics 显示文摘 | SANKARASUBRAMANIAN S KRISHNAMURTHY B | 2012 | Electrochimica Acta2012，70，： | 1 |
| 8 | Cyclooxygenase-2 expression in primary breast cancers predicts dissemination of cancer cells to the bone marrow显示文摘 | Lucci A Krishnamurthy S Singh B | 2009 | Breast Cancer Res Treat2009，117，1： | 1 |
| 9 | A Group-theoretic Model for Symmetric Interconnect Networks显示文摘 | Akers S B Krishnamurthy B | 1989 | IEEE Transactions on Computers1989，38，4： | 1 |
| 10 | A group-theoretic model for symmetric interconnection networks 显示文摘 | Akers S B Krishnamurthy B | 1989 | IEEE Transactions on Computers1989，38，4： | 1 |
| 11 | Deinterleaving Pulse Trains Using Discrete-Time Stochastic Dynamic-Linear Models显示文摘 | Moore John B Vikram Krishnamurthy | 1994 | IEEE Trans on Signal Processing1994，42，11： | 1 |
| 12 | Encapsulated cell grafts to treat cel-lular deficiencies and dysfunction显示文摘 | Krishnamurthy NV Gimi B | | 0，，： | 1 |
| 13 | A group-theoretic model for symmetric interconnection networks显示文摘 | Akers S B Krishnamurthy B | 1989 | IEEE Transactions on Computers1989，38，4： | 1 |
| 14 | MR Ima- ging and CT evaluation of congenital pulmonary vein abnor- malities in neonates and infants 显示文摘 | Vyas HV Greenberg B Krishnamurthy R | 2012 | Radiographics2012，32，： | 1 |
| 15 | Arrhythmogenic dilated cardiomyopathy due to a novel mutation in the desmoplakin gene显示文摘 | Krishnamurthy S Adhisivam B Hamilton RM | 2011 | Indian J Pediatr2011，78，7： | 1 |
| 16 | 带一个柔性关节的双关节平面运动机械手的受力控制理论显示文摘 | B O Choi K Krishnamurthy | 1991 | 机器人与自动化系统1991，，04： | 1 |
| 17 | Stable carbon isotope biogeochemistry of a shallow sand aquifer contaminated with fuel hydrocarbons 显示文摘 | Jia S F Michael J B Krishnamurthy R V | 2000 | Applied Geochemistry2000，15，2： | 1 |
| 18 | A group-theoretic model for symmetric interconnection networks显示文摘 | Akers S B Krishnamurthy B | 1989 | IEEE Transactions on Computers1989，38，4： | 1 |
| 19 | A group-theoretic model for interconnection networks显示文摘 | Akers S B Krishnamurthy B | 1989 | IEEE Transactions on computers1989，38，4： | 1 |
| 20 | Essential hypertension in early and mid-adolescence显示文摘 | Savitha MR Krishnamurthy B Fatthepur SS | | 0，，11： | 1 |
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