Impact of inflammatory bowel disease on post-cholecystectomy complications and hospitalization costs: A Nationwide Inpatient Sample study

BACKGROUND AND AIM: Our previous single-center study showed that patients with underlying inflammatory bowel disease (IBD) had a higher risk for post-cholecystectomy complications. The aim of the current population-based study was to verify whether concomitant IBD was indeed associated with an increased risk of post-cholecystectomy complications. METHODS: In this cross-sectional study, all 1, 155, 432 patients from the Nationwide Inpatient Sample (NIS) with a primary procedure of cholecystectomy were examined, and 5891 patients with IBD were compared with 1, 149, 541 patients without IBD from 2006 to 2008. RESULTS: There were no significant differences in age, gender, frequency of obesity, and post-operative mortality between the two groups. More patients in the IBD group had post-operative complications than the non-IBD group 398/5891 (6. 8%) vs. 55, 202/1, 149, 541 (4. 8%), p=0. 002). On multivariate analysis, the presence of Crohn's disease (CD) was associated with an increased risk for post-operative complications (odds ratio OR=1. 6; 95% confidence interval CI, 1. 2-2. 1, p=0. 003). The other risk factors for post-cholecystectomy complications were older age, male gender, African-American race, malnutrition and patients with higher co-morbidity index. The presence of ulcerative colitis (UC) was associated with a trend for increased complications (OR=1. 3, 95% CI 0. 8-2. 1, p=0. 08). Patients with IBD who underwent cholecystectomy incurred higher mean hospital costs (39, 651 vs. 35, 196, p=0. 006) and also stayed in the hospital 1. 2 days longer than those without underlying IBD. CONCLUSIONS: CD patients undergoing cholecystectomy were shown to have a significantly increased risk for postoperative complications, have a longer stay in the hospital, and incur higher hospitalization costs.