Days alive and out of hospital after laparoscopic cholecystectomy

Days alive and out of hospital (DAOH) is a metric that incorporates several outcomes into a single, standardized measure. This study aimed to explore the utility of DAOH in assessing the outcomes of a retrospective cohort of patients undergoing laparoscopic cholecystectomy (LC).

Patients undergoing LC at Auckland City Hospital between 1 January 2010 and 31 August 2015 were included. DAOH values were calculated for the 90 days from the date of surgery (DAOH₉₀ ) and described using median and interquartile ranges (IQR). DAOH₉₀ distributions were compared using a two-tailed (non-parametric) Wilcoxon-Mann-Whitney test.

1652 patients undergoing LC were studied. Patients experiencing complications (n = 70, 4.2%) had fewer DAOH₉₀ (median 83, IQR 79, 86) than patients who underwent uncomplicated LC (median 88, IQR 86, 88), P < 0.001. Patients who were converted to open cholecystectomy (n = 70, 4.2%) also had fewer DAOH₉₀ (median 82.5, IQR 79, 84) than patients who underwent uncomplicated LC, P < 0.001. Post-operative complications and conversion had a statistically significant effect on DAOH₉₀ at each of the tested quantiles, except for conversion at the 0.1 quantile.

DAOH₉₀ is readily calculable from existing New Zealand administrative data sources and is sensitive to the occurrence of complications after LC.