title: Factor Analysis Influencing Postoperative Hospital Stay and Medical Costs for Patients with Definite, Suspected, or Unmatched Diagnosis of Acute Cholecystitis according to the Tokyo Guidelines 2013.
abstract: Purpose. To identify significant independent preoperative factors influencing postoperative hospital stay (PHS) and medical costs (MC) in 171 patients who underwent cholecystectomy for benign gallbladder diseases and had definite, suspected, or unmatched acute cholecystitis (AC) diagnosis according to the Tokyo Guidelines 2013 (TG13). Methods. The 171 patients were classified according to the combination of diagnostic criteria including local signs of inflammation (A), systemic signs of inflammation (B), and imaging findings (C): A+ B+ C (definite diagnosis, n = 84), A+ B (suspected diagnosis, n = 25), (A or B) + C (n = 10), A (n = 41), and B (n = 11). Results. The A+ B + C and (A or B) + C groups had equivalent PHS and MC, suggesting that imaging findings were essential for AC diagnosis. PHS and MC were significantly increased in the order of severity grades based on TG13. Performance status (PS), white blood cell count, and severity grade were identified as preoperative factors influencing PHS by multivariate analysis, and significant independent preoperative factors influencing MC were age, PS, preoperative biliary drainage, hospital stay before surgery, albumin, and severity grade. Conclusion. PS and severity grade significantly influenced prolonged PHS and increased MC.
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan; Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Hayasaki
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan; Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kumamoto
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Matsumoto
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Miyahara
authors.affiliation: Department of Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie Prefecture 58512, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kusuta
authors.affiliation: Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Azumi
authors.affiliation: Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji