Gender based differences in management and outcomes of cholecystitis

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.