Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations

dc.contributor.authorLi, Suqing
dc.contributor.authorGuizzetti, Leonardo
dc.contributor.authorMa, Christopher
dc.contributor.authorShaheen, Abdel A.
dc.contributor.authorDixon, Elijah
dc.contributor.authorBall, Chad
dc.contributor.authorWani, Sachin
dc.contributor.authorForbes, Nauzer
dc.date.accessioned2023-07-30T00:02:39Z
dc.date.available2023-07-30T00:02:39Z
dc.date.issued2023-07-27
dc.date.updated2023-07-30T00:02:39Z
dc.description.abstractAbstract Background Gallstone disease poses a significant health burden in the United States. Choledocholithiasis and cholangitis are common complications of gallstone disease for which data on current epidemiological trends are lacking. We aimed to evaluate temporal changes in hospitalization, management, and outcomes for patients with choledocholithiasis and cholangitis. Methods The National Inpatient Sample was used to identify discharges for choledocholithiasis and cholangitis between 2005 and 2014. Temporal trends were evaluated via annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations of interest. Results From 189,362 unweighted discharges for choledocholithiasis and/or cholangitis, there was an increase in discharges for choledocholithiasis (APC 2.3%, 95% confidence intervals, CI, 1.9–2.7%) and cholangitis (APC 1.5%, 95% CI 0.7–2.2%). Procedural interventions were more likely at urban hospitals for choledocholithiasis (adjusted odds ratio, aOR, 2.94, 95% CI 2.72 to 3.17) and cholangitis (aOR 2.97, 95% CI 2.50 to 3.54). In-hospital mortality significantly decreased annually for choledocholithiasis (aOR 0.90, 95% CI 0.88 to 0.93) and cholangitis (aOR 0.93, 95% CI 0.89 to 0.97). In-hospital mortality between rural and urban centers was comparable for choledocholithiasis (aOR 1.16, 95% CI 0.89 to 1.52) and cholangitis (aOR 1.12, 95% CI 0.72 to 1.72). Conclusions Hospitalizations for choledocholithiasis and cholangitis have increased between 2005 and 2014, reflecting a growing burden of gallstone disease. Hospital mortality between urban and rural centers is similar, however urban centers have a higher rate of procedural interventions suggesting limitations to accessing procedural interventions at rural centers.
dc.identifier.citationBMC Gastroenterology. 2023 Jul 27;23(1):254
dc.identifier.urihttps://doi.org/10.1186/s12876-023-02868-3
dc.identifier.urihttps://hdl.handle.net/1880/116805
dc.identifier.urihttps://dx.doi.org/10.11575/PRISM/41647
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleEpidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations
dc.typeJournal Article
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