Cholecystectomy Is Risker in Male Patients

Abstract

Introduction: While cholecystitis has a female preponderance, some observe a trend towards more challenging disease in male patients. The confluence of sex and patient acuity has not been thoroughly investigated. We hypothesize that men present with worse disease compared with women, as evidenced by higher rates of open surgery and higher resource consumption. Methods: An inpatient registry from a 5-hospital system was queried for cholecystectomy procedures not associated with neoplasm or malignancy. Cases from 2015 to 2021 were included. Demographics, clinical and outcome variables were analyzed. Univariate analysis and multivariate logistic regression were performed. The data were de-identified before analysis and deemed exempt from IRB review, and were analyzed using R within R-Studio. Results: There were 2789 cholecystectomy patients, 1616 (58%) were women and 1173 (42%) were men. Demographics and baseline health characteristics differed across sex. Univariate analysis highlighted that males experienced more harms (1.35 vs 1.14; p = 0.002), more open approaches (18% vs 11%; p < 0.001), longer inpatient lengths of stays (median: 4 vs 3 days; p < 0.001), higher hospital cost ($15,694 vs $13,173; p < 0.001), increased laboratory orders (37.65 vs 30.01; p < 0.001), higher MS-DRG weight (2.104 vs 1.842; p < 0.001) and greater mortality risk (56% vs 36%; p < 0.001). Further, multivariate analysis found male cholecystectomy patients were correlated with higher instances of open surgical approach (OR: 1.80; p < 0.001), hospital readmission (OR: 1.50; p = 0.008), and higher cost (β: $981; R2: 0.27; p = 0.006). Conclusion: Inpatient male cholecystectomy patients present with worse disease and require more hospital resources.