Newly diagnosed and decompensated congestive heart failure is associated with increased rates of pneumonia, reintubation, and death following laparoscopic cholecystectomy

A NSQIP database review of 143,761 patients

Chad M. Hall, Daniel Jupiter, Justin L. Regner

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Laparoscopic cholecystectomy (LC) is routinely performed as an outpatient operation. NSQIP tracks acute or symptomatic congestive heart failure (CHF) within 30 days of the index operation. This study aims to quantify adverse events after LC and determine if patients with CHF may benefit from pre-operative optimization or post-operative admission. Materials and methods This is a retrospective NSQIP database review of all adults undergoing LC between 2008 and 2012. Comorbidities examined were acute or decompensated CHF, along with coronary artery disease, chronic obstructive pulmonary disease, diabetes, dyspnea, obesity, and smoking status. Bivariate and multivariate analyses determined the impact of these conditions on complications. Results LCs were performed electively in 131,081 patients and emergently in 12,680 patients. Pneumonia, reintubation or death in CHF patients occurred in 9% and 18% of these operations, respectively. The odds ratios, among those with CHF compared to those without, for pulmonary complications was 4.7 (p < 0.01, 95%CI: 3.38–6.6) in the elective and 3.7 (p < 0.01, 95%CI: 1.89–7.07) in the emergent populations. Conclusions Patients with acute or decompensated CHF may benefit from pre-operative cardiac optimization and post-operative admission to decrease the risk of pulmonary complications.

Original languageEnglish (US)
Pages (from-to)209-213
Number of pages5
JournalInternational Journal of Surgery
Volume35
DOIs
StatePublished - Nov 1 2016

Fingerprint

Laparoscopic Cholecystectomy
Pneumonia
Heart Failure
Databases
Lung
Dyspnea
Chronic Obstructive Pulmonary Disease
Comorbidity
Coronary Artery Disease
Outpatients
Multivariate Analysis
Obesity
Smoking
Odds Ratio
Population

Keywords

  • Congestive heart failure
  • Gallbladder
  • Gallstone
  • Laparoscopic cholecystectomy
  • Laparoscopic surgery
  • NSQIP

ASJC Scopus subject areas

  • Surgery

Cite this

@article{f8d680937d3b47568da28a20e81b68a9,
title = "Newly diagnosed and decompensated congestive heart failure is associated with increased rates of pneumonia, reintubation, and death following laparoscopic cholecystectomy: A NSQIP database review of 143,761 patients",
abstract = "Background Laparoscopic cholecystectomy (LC) is routinely performed as an outpatient operation. NSQIP tracks acute or symptomatic congestive heart failure (CHF) within 30 days of the index operation. This study aims to quantify adverse events after LC and determine if patients with CHF may benefit from pre-operative optimization or post-operative admission. Materials and methods This is a retrospective NSQIP database review of all adults undergoing LC between 2008 and 2012. Comorbidities examined were acute or decompensated CHF, along with coronary artery disease, chronic obstructive pulmonary disease, diabetes, dyspnea, obesity, and smoking status. Bivariate and multivariate analyses determined the impact of these conditions on complications. Results LCs were performed electively in 131,081 patients and emergently in 12,680 patients. Pneumonia, reintubation or death in CHF patients occurred in 9{\%} and 18{\%} of these operations, respectively. The odds ratios, among those with CHF compared to those without, for pulmonary complications was 4.7 (p < 0.01, 95{\%}CI: 3.38–6.6) in the elective and 3.7 (p < 0.01, 95{\%}CI: 1.89–7.07) in the emergent populations. Conclusions Patients with acute or decompensated CHF may benefit from pre-operative cardiac optimization and post-operative admission to decrease the risk of pulmonary complications.",
keywords = "Congestive heart failure, Gallbladder, Gallstone, Laparoscopic cholecystectomy, Laparoscopic surgery, NSQIP",
author = "Hall, {Chad M.} and Daniel Jupiter and Regner, {Justin L.}",
year = "2016",
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doi = "10.1016/j.ijsu.2016.10.005",
language = "English (US)",
volume = "35",
pages = "209--213",
journal = "International Journal of Surgery",
issn = "1743-9191",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Newly diagnosed and decompensated congestive heart failure is associated with increased rates of pneumonia, reintubation, and death following laparoscopic cholecystectomy

T2 - A NSQIP database review of 143,761 patients

AU - Hall, Chad M.

AU - Jupiter, Daniel

AU - Regner, Justin L.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background Laparoscopic cholecystectomy (LC) is routinely performed as an outpatient operation. NSQIP tracks acute or symptomatic congestive heart failure (CHF) within 30 days of the index operation. This study aims to quantify adverse events after LC and determine if patients with CHF may benefit from pre-operative optimization or post-operative admission. Materials and methods This is a retrospective NSQIP database review of all adults undergoing LC between 2008 and 2012. Comorbidities examined were acute or decompensated CHF, along with coronary artery disease, chronic obstructive pulmonary disease, diabetes, dyspnea, obesity, and smoking status. Bivariate and multivariate analyses determined the impact of these conditions on complications. Results LCs were performed electively in 131,081 patients and emergently in 12,680 patients. Pneumonia, reintubation or death in CHF patients occurred in 9% and 18% of these operations, respectively. The odds ratios, among those with CHF compared to those without, for pulmonary complications was 4.7 (p < 0.01, 95%CI: 3.38–6.6) in the elective and 3.7 (p < 0.01, 95%CI: 1.89–7.07) in the emergent populations. Conclusions Patients with acute or decompensated CHF may benefit from pre-operative cardiac optimization and post-operative admission to decrease the risk of pulmonary complications.

AB - Background Laparoscopic cholecystectomy (LC) is routinely performed as an outpatient operation. NSQIP tracks acute or symptomatic congestive heart failure (CHF) within 30 days of the index operation. This study aims to quantify adverse events after LC and determine if patients with CHF may benefit from pre-operative optimization or post-operative admission. Materials and methods This is a retrospective NSQIP database review of all adults undergoing LC between 2008 and 2012. Comorbidities examined were acute or decompensated CHF, along with coronary artery disease, chronic obstructive pulmonary disease, diabetes, dyspnea, obesity, and smoking status. Bivariate and multivariate analyses determined the impact of these conditions on complications. Results LCs were performed electively in 131,081 patients and emergently in 12,680 patients. Pneumonia, reintubation or death in CHF patients occurred in 9% and 18% of these operations, respectively. The odds ratios, among those with CHF compared to those without, for pulmonary complications was 4.7 (p < 0.01, 95%CI: 3.38–6.6) in the elective and 3.7 (p < 0.01, 95%CI: 1.89–7.07) in the emergent populations. Conclusions Patients with acute or decompensated CHF may benefit from pre-operative cardiac optimization and post-operative admission to decrease the risk of pulmonary complications.

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