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  • Title: Barriers to elective cholecystectomy following emergency department discharge for symptomatic cholelithiasis.
    Author: Gazzetta J, Orjionwe R, Fesmire A, Craft S, Esry L, Gazzetta E, Benedict LA, Nix S.
    Journal: Am J Surg; 2024 Dec; 238():115837. PubMed ID: 39067082.
    Abstract:
    BACKGROUND: Patients with symptomatic cholelithiasis are often discharged from the Emergency Department (ED) and asked to follow-up for elective cholecystectomy. We aimed to identify the social determinants of health (SDOH) that serve as barriers to elective cholecystectomy and to assess the associated impact on patient outcomes. METHODS: We conducted a multi-institutional, retrospective cohort study of patients discharged from the ED with symptomatic cholelithiasis. Univariable logistic regression was used to assess for variables associated with re-presenting to the ED rather than for elective cholecystectomy. P values ​< ​0.05 identified significance. RESULTS: Univariate analysis identified lack of a primary care physician, Black race, self-pay, language other than English as the primary language, and unemployed status to be independently associated with re-presentation to the ED for biliary disease. CONCLUSIONS: Socially disadvantaged populations would benefit from surgery at the time of presentation to the ED versus being sent home for elective follow-up.
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