Postoperative adverse events of cholecystectomy in the Medicare population.

We explored the use of postoperative adverse events of cholecystectomy as possible screens for poor quality of care. Retrospective analysis of clinical data abstracted from hospital charts between 1985-1986 was conducted on a random sample of 3,182 cholecystectomy cases. Severity of illness models were developed predicting adverse events following cholecystectomy in patients with and without bile duct exploration. Outcome measures included 17 nonfatal adverse events and death within 30 days of admission. Adverse event rates were 23.2% for cases with bile duct exploration and 14.4% for cases without bile duct exploration. Cross-validated R-squareds and C-statistics showed that models had real, although modest, predictive power. We conclude that clinically meaningful adverse events of cholecystectomy can be successfully identified through chart abstraction.