Outcomes in the Utilization of Single Percutaneous Cholecystostomy in a Low-Income Population

• Published in: International journal of environmental research and public health 2017-12, Vol.14 (12), p.1601
• Main Authors: Lu, Ping, Yang, Nan-Ping, Chang, Nien-Tzu, Lai, K Robert, Lin, Kai-Biao, Chan, Chien-Lung
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ambulatory care; Calculus; Case-Control Studies; Cholecystectomy; Cholecystitis, Acute - surgery; Cholecystostomy - statistics & numerical data; Codes; Complications; Datasets; Expenditures; Female; Gallbladder; Gallbladder diseases; Hospice care; Hospital Mortality; Hospitals; Humans; Low income groups; Male; Medical personnel; Middle Aged; Mortality; Patient Discharge - statistics & numerical data; Patients; Population; Population studies; Populations; Poverty - statistics & numerical data; Propensity Score; Recurrence; Socioeconomic factors; Socioeconomics; Studies; Surgery; Surgical anastomosis; Taiwan; Welfare; Young Adult
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph14121601

Numerous studies have investigated the applicable populations for percutaneous cholecystostomy (PC) procedures, but the outcomes of PC in low-income populations (LIPs) have been insufficiently studied. Data for 11,184 patients who underwent PC were collected from the National Health Insurance Research Database of Taiwan during 2003 and 2012. The overall crude rate of single PC for the LIP was 64% higher than that for the general population (GP). After propensity score matching for the LIP and GP at a ratio of 1:5, the outcome analysis of patients who underwent PC showed that in-hospital mortality was significantly higher in the LIP group than in the GP group, but one-year recurrence was lower. The rates of 30-day mortality and in-hospital complications were higher for the LIP patients than for the GP patients, and the rate of routine discharge was lower, but the differences were not significant. In conclusion, LIP patients undergoing PC exhibit poor prognoses relative to GP patients, indicating that a low socioeconomic status has an adverse impact on the outcome of PC. We suggest that surgeons fully consider the patient's financial situation during the operation and further consider the possible poor post-surgical outcomes for LIP patients.