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Evaluation of cholecystectomy in older individuals using real-world data: a multilevel analysis based on a nationwide administrative database in Japan

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

In the present study, we aimed to evaluate the clinical outcomes of cholecystectomy in older individuals.

Methods

In this retrospective study, data from the Japanese Diagnosis Procedure Combination database on 96,620 patients who had undergone cholecystectomy at 1060 hospitals from 2018 to 2020 were analyzed. Patients were divided into five age groups: < 75, 75–79, 80–84, 85–89, and ≥ 90 years. Associations between postoperative outcomes and age group were investigated by logistic regression analysis. Mean differences between age groups in time to postoperative recovery and cost were also compared.

Results

Older patients had higher rates of poor scores for activities of daily living and preoperative comorbidity. Compared with the youngest age group (< 75 years), the odds ratios for in-hospital mortality were 3.00 (95% confidence interval, 1.74–5.19), 7.54 (4.73–12.01), 13.47 (8.21–22.14), and 27.64 (15.56–49.09), in the 75–79, 80–84, 85–89, and ≥ 90-year-old age group, respectively (all p < 0.001). Furthermore, the length of postoperative hospital stay and rates of postoperative complications, postoperative reintubation, and reoperation with general anesthesia increased significantly in parallel with increasing age, the highest rates being in the ≥ 90 year-old age group.

Conclusions

Our real-world data highlight the worse postoperative outcomes, including a higher mortality rate, in older patients undergoing cholecystectomy. Care should be taken when considering the indications for surgery in such patients.

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Acknowledgements

We thank Dr Trish Reynolds, MBBS, FRACP from Edanz Editing (www.edanzediting.com/ac), for editing a draft of this manuscript.

Funding

This study was funded by a Health Labour Sciences Research Grant from the Ministry of Health, Labour, and Welfare of Japan (Grant number: 20AA2005).

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Authors and Affiliations

  1. Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan

    Yasuhisa Mori, Takuya Oba, Norihiro Sato, Shiro Kohi, Toshihisa Tamura, Jun Nagata, Kazunori Shibao & Keiji Hirata

  2. Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan

    Makoto Okawara & Yoshihisa Fujino

  3. Occupational Health Data Science Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan

    Kenji Fujimoto

  4. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan

    Kiyohide Fushimi

  5. Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan

    Shinya Matsuda

Authors
  1. Yasuhisa Mori
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  2. Makoto Okawara
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  3. Kenji Fujimoto
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  4. Takuya Oba
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  5. Norihiro Sato
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  6. Shiro Kohi
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  7. Toshihisa Tamura
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  8. Jun Nagata
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  9. Yoshihisa Fujino
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  10. Kiyohide Fushimi
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  11. Shinya Matsuda
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  12. Kazunori Shibao
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  13. Keiji Hirata
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Contributions

All authors substantially contributed to the conception and design of the study. Dr O and Dr F contributed to the acquisition and interpretation of data. Dr M drafted the manuscript and all authors critically revised it for important intellectual content. All authors gave final contribution for this version to be published.

Corresponding author

Correspondence to Yasuhisa Mori.

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The authors declare no conflicts of interest for this article.

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Cite this article

Mori, Y., Okawara, M., Fujimoto, K. et al. Evaluation of cholecystectomy in older individuals using real-world data: a multilevel analysis based on a nationwide administrative database in Japan. J Gastroenterol 57, 433–440 (2022). https://doi.org/10.1007/s00535-022-01873-9

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  • DOI: https://doi.org/10.1007/s00535-022-01873-9

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