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Article

Heart Failure Is a Poor Prognosis Risk Factor in Patients Undergoing Cholecystectomy: Results from a Spanish Data-Based Analysis

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Internal Medicine Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC, Universidad Complutense, 28040 Madrid, Spain
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Fundación Para la Mejora de la Asistencia Sanitaria, 28008 Madrid, Spain
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Servicio de Medicina Preventiva, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Rúa da Choupana, s/n, 15706 Santiago, Spain
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Servicio de Control de Gestión, Hospital 12 de Octubre, 28041 Madrid, Spain
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Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
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Internal Medicine Department, Hospital Universitario de Fuenlabrada, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, 28942 Madrid, Spain
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Internal Medicine Department, Hospital Universitario Rey Juan Carlos, Facultad de Ciencias de la Salud, Alcorcón, Universidad Rey Juan Carlos, 28933 Madrid, Spain
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Author to whom correspondence should be addressed.
Academic Editor: Stanley W. Ashley
J. Clin. Med. 2021, 10(8), 1731; https://doi.org/10.3390/jcm10081731
Received: 20 March 2021 / Revised: 6 April 2021 / Accepted: 12 April 2021 / Published: 16 April 2021
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
Background: The incidence of cholecystectomy is increasing as the result of the aging worldwide. Our aim was to determine the influence of heart failure on in-hospital outcomes in patients undergoing cholecystectomy in the Spanish National Health System (SNHS). Methods: We conducted a retrospective study using the Spanish National Hospital Discharge Database. Patients older than 17 years undergoing cholecystectomy in the period 2007–2015 were included. Demographic and administrative variables related to patients’ diseases as well as procedures were collected. Results: 478,111 episodes of cholecystectomy were identified according to the data from SNHS hospitals in the period evaluated. From all the episodes, 3357 (0.7%) were excluded, as the result the sample was represented by 474,754 episodes. Mean age was 58.3 (+16.5) years, and 287,734 (60.5%) were women (p < 0.001). A primary or secondary diagnosis of HF was identified in 4244 (0.89%) (p < 0.001) and mean age was 76.5 (+9.6) years. A higher incidence of all main complications studied was observed in the HF group (p < 0.001), except stroke (p = 0.753). Unadjusted in-hospital mortality was 1.1%, 12.9% in the group with HF versus 1% in the non HF group (p < 0.001). Average length of hospital stay was 5.4 (+8.9) days, and was higher in patients with HF (16.2 + 17.7 vs. 5.3 + 8.8; p < 0.001). Risk-adjusted in-hospital mortality models’ discrimination was high in both cases, with AUROC values = 0.963 (0.960–0.965) in the APRG-DRG model and AUROC = 0.965 (0.962–0.968) in the CMS adapted model. Median odds ratio (MOR) was high (1.538 and 1.533, respectively), stating an important variability of risk-adjusted outcomes among hospitals. Conclusions: The presence of HF during admission increases in hospital mortality and lengthens the hospital stay in patients undergoing cholecystectomy. However, mortality and hospital stay have significantly decreased during the study period in both groups (HF and non HF patients). View Full-Text
Keywords: heart failure; cholecystectomy surgery; in-hospital outcomes; length of stay heart failure; cholecystectomy surgery; in-hospital outcomes; length of stay
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MDPI and ACS Style

Marco-Martínez, J.; Elola-Somoza, F.J.; Fernández-Pérez, C.; Bernal-Sobrino, J.L.; Azaña-Gómez, F.J.; García-Klepizg, J.L.; Andrès, E.; Zapatero-Gaviria, A.; Barba-Martin, R.; Calvo-Manuel, E.; Canora-Lebrato, J.; Lorenzo-Villalba, N.; Méndez-Bailón, M. Heart Failure Is a Poor Prognosis Risk Factor in Patients Undergoing Cholecystectomy: Results from a Spanish Data-Based Analysis. J. Clin. Med. 2021, 10, 1731. https://doi.org/10.3390/jcm10081731

AMA Style

Marco-Martínez J, Elola-Somoza FJ, Fernández-Pérez C, Bernal-Sobrino JL, Azaña-Gómez FJ, García-Klepizg JL, Andrès E, Zapatero-Gaviria A, Barba-Martin R, Calvo-Manuel E, Canora-Lebrato J, Lorenzo-Villalba N, Méndez-Bailón M. Heart Failure Is a Poor Prognosis Risk Factor in Patients Undergoing Cholecystectomy: Results from a Spanish Data-Based Analysis. Journal of Clinical Medicine. 2021; 10(8):1731. https://doi.org/10.3390/jcm10081731

Chicago/Turabian Style

Marco-Martínez, Javier, Francisco J. Elola-Somoza, Cristina Fernández-Pérez, José L. Bernal-Sobrino, Francisco J. Azaña-Gómez, José L. García-Klepizg, Emmanuel Andrès, Antonio Zapatero-Gaviria, Raquel Barba-Martin, Elpidio Calvo-Manuel, Jesus Canora-Lebrato, Noel Lorenzo-Villalba, and Manuel Méndez-Bailón. 2021. "Heart Failure Is a Poor Prognosis Risk Factor in Patients Undergoing Cholecystectomy: Results from a Spanish Data-Based Analysis" Journal of Clinical Medicine 10, no. 8: 1731. https://doi.org/10.3390/jcm10081731

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