Ten-Year Trends in Mortality with Symptomatic Gallstone Disease and Emergency Cholecystectomy in New Jersey

Abstract

Introduction: The epidemiology of death from symptomatic gallstone disease (SGD) may offer insight into current shortcomings of surgical and non-surgical therapy for SGD. Our aim was to explore in New Jersey (NJ) secular trends in mortality with SGD overall and mortality after emergency cholecystectomy. Methods: National Center for Health Statistics Restricted Mortality Data and Healthcare Cost and Utilization Project (HCUP) State Inpatient Data were used to examine NJ trends in calendar years 2009 to 2018. Outcomes were any death with SGD and inpatient death after emergency cholecystectomy. Death count and calendar year data were fit using simple linear regression. Results: There were 1580 deaths overall with 644 (40.76%) of those deaths after emergency cholecystectomy. A +2.05% relative change in deaths overall compared with a -57.58% relative change in deaths after emergency cholecystectomy from 2009 to 2018. Deaths overall remained flat [slope estimate -0.90; 95% CI -4.30, 2.51] while a downward linear trend occurred for deaths after emergency cholecystectomy [slope estimate -5.19; 95% CI -7.84, -2.53]. Conclusion: While overall rate of death with SGD in NJ was flat over a decade, substantial decreases were observed in inpatient death after emergency cholecystectomy. This needs to be reproduced in other states. However, any population trends in incidence of emergency vs non-emergency surgery for SGD are largely unknown. Examining medical and procedural treatments of emergency and non-emergency disease in addition to surgery may help to prevent mortality due to SGD.