Gender based differences in management and outcomes of cholecystitis

Abstract

Background: During the reproductive years, women have a 4-fold higher prevalence of gallstones than men, making gallbladder disease a critically important topic in women's health. Among age-matched women and men hospitalized for cholecystitis, gender based differences in demographics, management, and economic and clinical outcomes were identified.

Methods: A cross-sectional study was conducted using the Nationwide Inpatient Sample. Outcomes were mortality, complications, length of stay, and cost.

Results: Women accounted for 65% of admissions for cholecystitis, with women more likely to have shorter time to surgery (1.6 vs. 1.9 days) and laparoscopy (86 vs. 76%) (P < .05). After cholecystectomy, women had lower mortality (.6% vs. 1.1%), fewer complications (16.9 vs. 24.1), shorter lengths of stay (4.2 vs. 5.4 days), and lower costs ($10,556 vs. $13,201) (P < .05). On multivariate analysis of age-matched patients, women had lower odds of mortality (odds ratio [OR], .75), complications (OR, .86), length of stay (OR, .95), and cost (OR, .93). Longer time to surgery and open cholecystectomy were independent predictors of worse outcomes.

Conclusions: In cholecystitis and cholecystectomy, women have better clinical and economic outcomes then age-matched men.

Keywords: Biliary disease; Cholecystectomy; Gender; Outcomes.