Management of acute mild gallstone pancreatitis under acute care surgery: Should patients be admitted to the surgery or medicine service?

Narong Kulvatunyou; John Watt; Randall S. Friese; Lynn Gries; Donald J. Green; Bellal Joseph; Terence OKeeffe; Andrew L. Tang; Gary Vercruysse; Peter Rhee

doi:10.1016/j.amjsurg.2014.09.003

Management of acute mild gallstone pancreatitis under acute care surgery: Should patients be admitted to the surgery or medicine service?

Narong Kulvatunyou
, John Watt
, Randall S. Friese
, Lynn Gries
, Donald J. Green
, Bellal Joseph
, Terence OKeeffe
, Andrew L. Tang
, Gary Vercruysse
, Peter Rhee

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.

Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.

Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs ($11,492 ± 6,480 vs $16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.

Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.

Original language	English (US)
Pages (from-to)	981-987
Number of pages	7
Journal	American Journal of Surgery
Volume	208
Issue number	6
DOIs	https://doi.org/10.1016/j.amjsurg.2014.09.003
State	Published - Dec 1 2014
Externally published	Yes

Keywords

Gallstone pancreatitis
Medicine service
Surgery service

ASJC Scopus subject areas

Surgery

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10.1016/j.amjsurg.2014.09.003

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title = "Management of acute mild gallstone pancreatitis under acute care surgery: Should patients be admitted to the surgery or medicine service?",

abstract = "Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs (\$11,492 ± 6,480 vs \$16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.",

keywords = "Gallstone pancreatitis, Medicine service, Surgery service",

author = "Narong Kulvatunyou and John Watt and Friese, \{Randall S.\} and Lynn Gries and Green, \{Donald J.\} and Bellal Joseph and Terence OKeeffe and Tang, \{Andrew L.\} and Gary Vercruysse and Peter Rhee",

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T1 - Management of acute mild gallstone pancreatitis under acute care surgery

T2 - Should patients be admitted to the surgery or medicine service?

AU - Kulvatunyou, Narong

AU - Watt, John

AU - Friese, Randall S.

AU - Gries, Lynn

AU - Green, Donald J.

AU - Joseph, Bellal

AU - OKeeffe, Terence

AU - Tang, Andrew L.

AU - Vercruysse, Gary

AU - Rhee, Peter

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs ($11,492 ± 6,480 vs $16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.

AB - Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs ($11,492 ± 6,480 vs $16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.

KW - Gallstone pancreatitis

KW - Medicine service

KW - Surgery service

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Management of acute mild gallstone pancreatitis under acute care surgery: Should patients be admitted to the surgery or medicine service?

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