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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 | ACC/AHA guidelines for the management of patients with unstable angina and non–st-segment elevation myocardial infarction显示文摘 | Eugene Braunwald Elliott M Antman John W Beasley Robert M Califf Melvin D Cheitlin Judith S Hochman Robert H Jones Dean Kereiakes Joel Kupersmith Thomas N Levin Carl J Pepine John W Schaeffer Earl E Smith David E Steward Pierre Theroux Raymond J Gibbons J | 2000 | Journal of the American College of Cardiology2000，，3： | 4 |
| 3 | Measuring ecosystem health显示文摘 | Schaeffer D J Henricks E E Kerster H W | 1998 | Environmental Management1998，12，： | 2 |
| 4 | Leukocyte and Bacterial Counts Do Not Correlate With Severity of Symptoms in Men With Chronic Prostatitis: The National Institutes of Health Chronic Prostatitis Cohort Study显示文摘 | Anthony J. Schaeffer Jill S. Knauss J. Richard Landis Kathleen J. Propert Richard B. Alexander Mark S. Litwin J. Curtis Nickel Michael P. O’leary Robert B. Nadler Michel A. Pontari Daniel A. Shoskes Scott I. Zeitlin Jackson E. Fowler Carissa A. Mazurick J | 2002 | The Journal of Urology2002，，3： | 2 |
| 5 | Demographic and clinical characteristics of men with chronic prostatitis:the national institutes of health chronic prostatitis cohort study显示文摘 | Schaeffer A J Landis J R Knauss | 2002 | J Urol2002，168，： | 1 |
| 6 | The role of cytokines in prostatitis 显示文摘 | Jang T L Schaeffer A J | 2003 | World J Uroi2003，21，2： | 1 |
| 7 | Selective and non- selective autophagic degradation of mitochondria in yeast 显示文摘 | Kissova I Salin B Schaeffer J | 2007 | Autophagy2007，3，4： | 1 |
| 8 | Relationships between soybean components and tofu texture显示文摘 | SCHAEFFER M J LOVE J | 1992 | Food Qual1992，15，： | 1 |
| 9 | Relationships between soy- bean components and tofu texture 显示文摘 | SCHAEFFER M J LOVE J | 1992 | J of Food Quali- ty1992，15，： | 1 |
| 10 | 9-(2- hydroxyethoxymethyl) guanine activity against viruses of the herpes group显示文摘 | Schaeffer H J Beauehamp L Miranda P de | 1978 | Nature1978，272，： | 1 |
| 11 | Abernethy malformation type Ⅱwith nephrotic syndrome and other multisystemic presentation:an illustrative case for understanding pathogenesis of extrahepatic complication of congenital portosystemic shunt显示文摘 | Schaeffer DF Laiq S Jang H J | | 0，，03： | 1 |
| 12 | Factor Xa activates endothelial cells by a receptor cascade between EPR-1 and PAR2显示文摘 | Bono F Schaeffer P Herault J P | 2000 | Arterioscler Thromb Vasc Biol2000，20，11： | 1 |
| 13 | On symmetric solutions of the relativistic Vlasov- Poisson system 显示文摘 | Glassey R T Schaeffer J | 1985 | Comm Math Phys1985，101，： | 1 |
| 14 | Potential for reduction of CO2 emissions and a low-carbon scenario for the Brazilian industrial sector显示文摘 | Henriques J M FDantas F Schaeffer R | | 0，，04： | 1 |
| 15 | Estimates of genetic parameters for a test day model with random regressions for yield traits of first lactation Holsteins显示文摘 | Jamrozik J Schaeffer L R | 1997 | Journal of Dairy Science1997，80，： | 1 |
| 16 | PGC-1a coactivates PDK4 gene phan nuclear receptor ERRα: a expression via the or for tran scriptional control of muscle glucose metabolism 显示文摘 | WENDE A R HUSS J M SCHAEFFER P J | 2005 | Mol Cell Biol2005，25，10： | 1 |
| 17 | Leukocyte and bacterial countsdo not correlate with severity of symptoms in men with chronic prostatitis : the National Institutes of Health Chronic Prostatitis Cohort Study 显示文摘 | Schaeffer A J Knauss JS Landis JR | 2002 | J Uro12002，168，3： | 1 |
| 18 | Leukocyte and bacterial counts do not correlate with severity of symptoms in men with chronic prostatitis: the National Institutes of Health Chronic Prostatitis Cohort Study显示文摘 | Schaeffer A J Knauss JS Landis JR et ol | 2002 | J Urol2002，168，3： | 1 |
| 19 | A class of nonharmonic fourier series显示文摘 | Duffin R J Schaeffer A G | 1952 | Trans Am Math Soc1952，72，： | 1 |
| 20 | Lipopolysaccharide-based enzyme-linked immunosorbent assay for experimental use in detection of antibodies to Lawsonia intracellularis in pigs 显示文摘 | Kroll J J Eichmeyer M A Schaeffer M L | 2005 | Clinical and Diagnostic Laboratory Immunology2005，12，6： | 1 |
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