Thirty-Day Readmission Among Patients With Uncomplicated Choledocholithiasis: A Nationwide Readmission Database...

Area of Science:

• Gastroenterology
• Health Services Research
• Public Health

Background:

• Uncomplicated choledocholithiasis presents a significant public health challenge.
• Understanding 30-day hospital readmission rates is crucial for improving patient outcomes and managing healthcare resources.
• The economic burden and mortality associated with choledocholithiasis readmissions require thorough investigation.

Purpose of the Study:

• To determine the 30-day hospital readmission rate for uncomplicated choledocholithiasis in the United States.
• To analyze the impact of these readmissions on patient mortality and healthcare utilization.
• To identify independent risk factors associated with 30-day readmissions.

Main Methods:

• Analysis of the Nationwide Readmission Database (2016-2018) for nonelective adult admissions with uncomplicated choledocholithiasis.
• Primary outcome: all-cause 30-day readmission rate.
• Secondary outcomes: reasons for readmission, mortality, procedures, length of stay, hospitalization costs, and charges. Cox regression analysis identified risk factors.

Main Results:

• The 30-day readmission rate was 9.3%.
• Readmissions were primarily due to biliary/pancreatic disorders (36.6%) and postprocedural complications (10.3%).
• Readmitted patients had higher mortality (2.0% vs. 0.4%), received fewer procedures (ERCP, LC), and incurred significant costs ($112M in costs, $470M in charges).

Conclusions:

• A 9.3% 30-day readmission rate for uncomplicated choledocholithiasis signifies substantial associated mortality, morbidity, and resource use.
• Predictors for readmission include male sex, Medicare insurance, higher comorbidity scores, lack of specific procedures during index admission, and hospital characteristics.
• Targeted interventions for high-risk patients and healthcare systems are needed to reduce readmissions and their associated burdens.