医学
内镜逆行胰胆管造影术
逻辑回归
优势比
可能性
人口学
急诊医学
内科学
胰腺炎
社会学
作者
Shanthini Kuduva Rajan,Sowmya Madireddy,Paul Rahul Jaladi,Virendrasinh Ravat,Anum Masroor,Uwandu Queeneth,Wahida Rashid,Rikinkumar S Patel
出处
期刊:Cureus
[Cureus, Inc.]
日期:2019-07-25
被引量:4
摘要
Objectives Our objective in this study is, firstly, to determine postoperative (POI) rates in endoscopic retrograde cholangiopancreatography (ERCP) procedures stratified by patients' demographic and hospitals' characteristics in the United States, and secondly, to evaluate the demographic and comorbid risk factors associated with POI in ERCP inpatients, as well as its impact on the length of stay (LOS) and total charges. Methods The total sample of 28,525 inpatients with a principal procedure of ERCP from the Nationwide Inpatient Sample (NIS) was included and grouped by co-diagnosis of POI (N=300, 1.05%). We used a logistic regression model and descriptive statistics for the POI rate estimates. Results High POI rate was seen in males (1.14%), and adults (36-50 years, 1.25%) with 2.65 times (95% CI 1.69-4.12) higher odds compared to young adults. POI rate in ERCP inpatients varied widely according to geographic region: higher in the West (1.46%) and Northeast (1.20%) and lowest in the Midwest (0.70%). As per the hospital characteristics, inpatients in public (1.26%), urban teaching (1.39%) and small bed-size (1.27%) hospitals had higher POI rates. ERCP inpatients with POI had higher odds of association with comorbid HIV infection (OR 1.55, 95% CI 1.13-2.12) and diabetes (OR 1.43, 95% CI 1.09-1.85). ERCP inpatients with POI had a significantly longer length of stay (LOS) by 5.2 days and higher total charges by USD 53,966 than inpatients without POI. Conclusions POI is associated with acute inpatient care, with longer hospitalization stays and higher costs, leading to increased healthcare burdens. The main goal is to identify the risk factors and to prevent POI with prophylactic antibiotics.
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