A Nationwide Examination of Trends of Hospital Admissions for Acute Cholecystitis in the United States From 1997-2012

Abstract

Introduction: Acute Cholecystitis is a fairly common inpatient diagnosis in internal medicine and gastroenterology. The aim of this study was to use a national database of U.S. hospitals to evaluate the incidence and costs of hospital admission associated with acute cholecystitis. Methods: We analyzed the National Inpatient Sample Database (NIS) for all patients in which acute cholecystitis (ICD-9 code: 574.00, 574.01, 574.30, 574.31, 574.60, 574.61, 575.0) was the principal discharge diagnosis from 1997-2012. The NIS is the largest all-payer inpatient database in the United States containing data from approximately 8 million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay and associated hospital costs over the study period was determined by using the Chi-square test for trends. Results: In 1997, there were 149,661 admissions with a principal discharge diagnosis of acute cholecystitis as compared to 215,995 in 2012 (GoF test, p < 0.001, Figure 1). The mean length of stay for acute cholecystitis decreased by 17 % between 1997 and 2012 from 4.7 days to 3.9 days (p>0.05). However, during this period the mean hospital charges increased by 195.4 % from $14608 per patient in 1997 to $43158 per patient in 2012 (p < 0.001, Figure 2). The in-hospital mortality rate also decreased slightly from 0.86% in 1997 to 0.55% in 2012 (p>0.05).Figure 1Figure 2Conclusion: The number of inpatient discharges related to acute cholecystitis have significantly increased over the last 16 years in the United States. There has been a great increase in the charges associated with these discharges as well. However, there has been a gradual decline in the mean length of stay and the inpatient mortality. Inpatient costs associated with acute cholecystitis contribute significantly to the total healthcare bill. Further research on cost-effective evaluation and management of acute cholecystitis is required.