Ambur Vishnu, Taghavi Sharven, Kadakia Sagar, Jayarajan Senthil, Gaughan John, Sjoholm Lars Ola, Pathak Abhijit, Santora Thomas, Rappold Joseph, Goldberg Amy J
Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
Barnes Jewish Hospital/Washington University in St. Louis, Department of Surgery, St Louis, MO, USA.
Am J Surg. 2017 Jan;213(1):100-104. doi: 10.1016/j.amjsurg.2016.04.012. Epub 2016 Jun 14.
This study was performed to evaluate the effect of socioeconomic status (SES) on outcomes after cholecystectomy.
The National Inpatient Sample (NIS) database (2005 to 2011) was queried for patients undergoing cholecystectomy. Clinically relevant variables were used to examine clinical characteristics, postoperative complications, and mortality. SES was investigated by examining income quartile.
More than 2 million patients underwent cholecystectomy during this period. They were divided into quartiles by SES. The lowest cohort was younger (50 years, P < .001) and had the lowest Charlson Comorbidity Index (2.08, P < .001). This cohort was more likely African American (15.8%, P < .001) and more likely to have Medicaid (19.2%, P < .001). Using split-sample validation and multivariate analysis, lower SES, Charlson comorbidity Index, and Medicaid recipients were associated with increased mortality.
Patients with Medicaid and lower SES had poorer outcomes after cholecystectomy.
本研究旨在评估社会经济地位（SES）对胆囊切除术后结局的影响。
查询国家住院患者样本（NIS）数据库（2005年至2011年）中接受胆囊切除术的患者。使用临床相关变量来检查临床特征、术后并发症和死亡率。通过检查收入四分位数来研究社会经济地位。
在此期间，超过200万患者接受了胆囊切除术。他们按社会经济地位分为四分位数。最低四分位数组患者更年轻（50岁，P <.001），且Charlson合并症指数最低（2.08，P <.001）。该组更可能是非裔美国人（15.8%，P <.001），且更可能有医疗补助（19.2%，P <.001）。通过拆分样本验证和多变量分析，较低的社会经济地位、Charlson合并症指数以及医疗补助接受者与死亡率增加相关。
有医疗补助且社会经济地位较低的患者胆囊切除术后结局较差。
