P2126 - Thirty-Day Readmission Among Patients With Uncomplicated Choledocholithiasis: A Nationwide Readmission Database Analysis

Yichen Wang, MD¹, Dermot Murphy, MD¹, Si Li, MD², Bing Chen, MD³, Heather Peluso, DO⁴, Vikram Sondhi, MD¹, Marwan Abougergi, MD^5
1Mercy Medical Center, Trinity Health of New England, Springfield, MA; ²Wright Center for Graduate Medical Education, Scranton, PA; ³Mount Sinai Morningside and West Hospitals, New York, NY; ⁴Prisma Health Upstate, Simpsonville, SC; ⁵Medical University of South Carolina, Columbia, SC

Introduction: We aimed to determine the rate of 30-day hospital readmissions of uncomplicated choledocholithiasis and its impact on mortality and healthcare use in the United States.

Methods: Non-elective admissions for adults with uncomplicated choledocholithiasis were selected from the Nationwide Readmission Database 2016-2018. The primary outcome was the all-cause 30-day readmission rate. Secondary outcomes were reasons for readmission, readmission mortality rate, procedures, and resource use (length of stay and total hospitalization costs and charges). Independent risk factors for readmission were identified using Cox regression analysis.

Results: The 30-day rate of readmission was 9.3%. Biliary and pancreatic disorders and postprocedural complications accounted for 36.6% and 10.3% of readmission, respectively. The mortality rate among patients readmitted to the hospital was higher than that for index admissions (2.0% vs. 0.4%, P < .01). Readmitted patients were less likely to receive endoscopic retrograde cholangiopancreatography (ERCP) (61% vs. 69%, P < .01) and laparoscopic cholecystectomy (LC) (12.5% vs. 26%, P < .01) during the index admissions. A total of 42,150 hospital days was associated with readmission, and the total healthcare in-hospital economic burden was $112 million (in costs) and $470 million (in charges). Independent predictors of readmission were male sex, Medicare (compared to private) insurance, higher Elixhauser comorbidity score, no ERCP or LC, postprocedural complications of the digestive system, hemodynamic or respiratory support, urban hospitals, and lower hospital volume of uncomplicated choledocholithiasis.

Discussion: The uncomplicated choledocholithiasis 30-day readmission rate is 9.3%. Readmission was associated with higher mortality, morbidity, and resource use. Multiple independent predictors of readmission were identified.



Disclosures:


Yichen Wang, MD¹, Dermot Murphy, MD¹, Si Li, MD², Bing Chen, MD³, Heather Peluso, DO⁴, Vikram Sondhi, MD¹, Marwan Abougergi, MD⁵. P2126 - Thirty-Day Readmission Among Patients With Uncomplicated Choledocholithiasis: A Nationwide Readmission Database Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.