title: How sick are dialysis patients undergoing cholecystectomy? Analysis of 92,672 patients from the American College of Surgeons National Surgical Quality Improvement Program database.
abstract: BACKGROUND
  Although cholecystectomy is one of the most common surgical procedures performed in the United States, there is an absence of data on the risks of cholecystectomy in dialysis patients. Our objective was to analyze the outcomes of cholecystectomy in dialysis patients.
  
  
  METHODS
  Using the American College of Surgeons National Surgical Quality Improvement Program database, we selected all patients who underwent cholecystectomy from 2005 to 2010. Univariate analysis was performed and logistic and linear regression models were used to obtain risk-adjusted outcomes. The main outcomes were morbidity, mortality, and length of stay.
  
  
  RESULTS
  Dialysis was associated with a higher risk of 30-day postoperative morbidity (16.1% vs 3.8%, adjusted odds ratio 1.91, 95% confidence interval 1.18 to 3.10), but not mortality. The average length of stay following any cholecystectomy was 4.1 days longer for dialysis patients (5.5 vs 1.4 days, P < .0001).
  
  
  CONCLUSIONS
  Patients on dialysis who undergo cholecystectomy are at a higher risk for postoperative morbidity, but not mortality.
authors.affiliation: Department of Surgery, SUNY Downstate College of Medicine, Brooklyn, NY, USA.
authors.forename: Sophia F
authors.initials: SF
authors.lastname: Tam
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Au
authors.affiliation: Department of Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
authors.forename: Wataru
authors.initials: W
authors.lastname: Sako
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Alfonso
authors.affiliation: Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA. Electronic address: gainosuke.sugiyama@downstate.edu.
authors.forename: Gainosuke
authors.initials: G
authors.lastname: Sugiyama
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D002763:Cholecystectomy; D016208:Databases, Factual; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D006435:Renal Dialysis; D012086:Reoperation / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D018805:Sepsis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: ACS NSQIP; Abdominal surgery; Cholecystectomy; Dialysis; End-stage renal disease; Hemodialysis