S1285 Gallstone Ileus: How Common Is the Uncommon? A Nationwide Perspective With Overview of Hospitalization Trends, Cost of Care, and Outcomes
Notice bibliographique
Résumé
INTRODUCTION: Gallstone ileus (GSI) is a rare complication of gallstone disease estimated to account for 1%–4% of all bowel obstructions. It is the result of gallstone impaction in the small bowel through a biliary-enteric fistula. Limited epidemiological data exists on the number of hospitalizations, demographic variations, cost of care, comorbidity measures, and outcomes for GSI. METHODS: We analyzed the National Inpatient Sample (NIS) database for all hospitalizations with GSI (ICD-9 code 560.31) as primary or secondary diagnosis during the period from 2001-2011. NIS is the largest all-payer inpatient care database in the United States, containing data on more than 7 million hospital stays. Its large sample size is ideal for developing national and regional estimates. Statistical significance of variation were determined using Cochran-Armitage trend test. RESULTS: Between 2001 and 2011, number of hospitalizations for GSI increased from 1048 to 1255 (P < 0.0001, Figure 1A). GSI was found to be more common in women (P = 0.12) and Caucasians (P = 0.03). Although age group 65–79 remained the most commonly affected, age group 50-64 showed the greatest rise from 17.8% to 25.8% (P < 0.0001, Figure 1B). South remained the most commonly affected region (P = 0.22) throughout the study period. There was a significant rise in the West from 20.6% to 25.0% (P = 0.002) with a concurrent decrease in the Northeast from 24.2% to 20.3% (P = 0.04). A proportional decrease in the number of hospitalizations was seen at both, urban non-teaching (45.6% to 41.6%, P = 0.29, Figure 1C) and rural hospitals (19.9% to 9.9%, < 0.0001, Figure 1C), while the number increased at urban teaching hospitals (34.5% to 46.7%, P < 0.0001, Figure 1C). There was an overall increase in the cost of care from $17,285 to $23,739 (P < 0.0001, Figure 1D) whereas the mean length of stay ranged from 9.5 to 11.1 days (P = 0.28). Overall mortality ranged from 4.3% to 8.6% (P = 0.005). Some of the most commonly associated comorbid conditions with GSI were hypertension, fluid and electrolyte disorders, diabetes mellitus, anemia, and chronic pulmonary disease (Figure 2). CONCLUSION: A significant rise in the number of hospitalizations with GSI was found with interesting demographic variations and association with comorbidities. Although there was no significant change in their length of stay, there was a significant rise in the cost of care during the study period, perhaps due to increased use of newer, more advanced, diagnostic and treatment modalities.Figure 1Figure 2
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».