Factors associated with prolonged stay after laparoscopic cholecystectomy in elderly patients.
BACKGROUND
Laparoscopic cholecystectomy in elderly patients has been linked to higher complication rates and longer lengths of stay. The purpose of this study was to identify risk factors associated with prolonged postoperative hospitalization in elderly patients undergoing laparoscopic cholecystectomy.


METHODS
The records of 287 patients aged 65 years or older, who underwent successful laparoscopic cholecystectomy between January 2001 and July 2006, were retrospectively reviewed. Clinical data was abstracted from the chart and compared between patients with a shorter or longer postoperative stay.


RESULTS
The median postoperative hospital stay was three days (interquartile range 3-5). Forty-eight patients had complications, with an overall morbidity of 16% and mortality of 0.7%. The only independent predictor of prolonged postoperative stay was the occurrence of any major complication [odds ratio, 3.144; 95% confidence interval (CI), 1.882-5.251]. The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and underlying chronic obstructive pulmonary disease were independently associated with major complications.


CONCLUSIONS
A major complication is the most important cause of prolonged hospital stay after laparoscopic cholecystectomy in the elderly. No specific comorbidity has direct impact on the duration of hospitalization, but pulmonary disease is associated with increased risk of major complications.
Cheng
Shih-Ping
SP
Department of Surgery, Mackay Memorial Hospital, 92, Sec 2, Chung-Shan North Road, Taipei, 10449, Taiwan.
Chang
Yuan-Ching
YC
Liu
Chien-Liang
CL
Yang
Tsen-Long
TL
Jeng
Kuo-Shyang
KS
Lee
Jie-Jen
JJ
Liu
Tsang-Pai
TP
D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D042882:Gallstones / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome