title: Does socioeconomic status predict outcomes after cholecystectomy?
abstract: BACKGROUND
  This study was performed to evaluate the effect of socioeconomic status (SES) on outcomes after cholecystectomy.
  
  
  METHODS
  The National Inpatient Sample (NIS) database (2005 to 2011) was queried for patients undergoing cholecystectomy. Clinically relevant variables were used to examine clinical characteristics, postoperative complications, and mortality. SES was investigated by examining income quartile.
  
  
  RESULTS
  More than 2 million patients underwent cholecystectomy during this period. They were divided into quartiles by SES. The lowest cohort was younger (50 years, P < .001) and had the lowest Charlson Comorbidity Index (2.08, P < .001). This cohort was more likely African American (15.8%, P < .001) and more likely to have Medicaid (19.2%, P < .001). Using split-sample validation and multivariate analysis, lower SES, Charlson comorbidity Index, and Medicaid recipients were associated with increased mortality.
  
  
  CONCLUSIONS
  Patients with Medicaid and lower SES had poorer outcomes after cholecystectomy.
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA. Electronic address: Vishnu.Ambur@tuhs.temple.edu.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Ambur
authors.affiliation: Barnes Jewish Hospital/Washington University in St. Louis, Department of Surgery, St Louis, MO, USA.
authors.forename: Sharven
authors.initials: S
authors.lastname: Taghavi
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
authors.forename: Sagar
authors.initials: S
authors.lastname: Kadakia
authors.affiliation: Barnes Jewish Hospital/Washington University in St. Louis, Department of Surgery, St Louis, MO, USA.
authors.forename: Senthil
authors.initials: S
authors.lastname: Jayarajan
authors.affiliation: Temple University School of Medicine, Biostatistics Consulting Center, Philadelphia, PA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
authors.forename: Lars Ola
authors.initials: LO
authors.lastname: Sjoholm
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Santora
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rappold
authors.affiliation: Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Goldberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002763:Cholecystectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012923:Social Class; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Cholecystectomy; Income; Medicaid; National inpatient sample; Socioeconomic status