Cholecystectomy during Index Admission for Acute Biliary Pancreatitis Lowers 30-Day Readmission Rates

Somashekar G. Krishna, Andrew J. Kruger, Nishi Patel, Alice Hinton, Dhiraj Yadav, Darwin L. Conwell

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objectives Few studies have evaluated national readmission rates after acute pancreatitis (AP) in the United States. We sought to evaluate modifiable factors impacting 30-day readmissions after AP hospitalizations. Methods We used the Nationwide Readmission Database (2013) involving all adults with a primary discharge diagnosis of AP. Multivariable logistic regression models assessed independent predictors for specific outcomes. Results Among 180,480 patients with AP index admissions, 41,094 (23%) had biliary AP, of which 10.5% were readmitted within 30 days. The 30-day readmission rate for patients who underwent same-admission cholecystectomy (CCY) was 6.5%, compared with 15.1% in those who did not (P < 0.001). Failure of index admission CCY increased the risk of readmissions (odds ratio [OR], 2.27; 95% confidence interval [CI], 2.04-2.56). Same-admission CCY occurred in 55% (n = 19,274) of patients without severe AP. Severe AP (OR, 0.73; 95% CI, 0.65-0.81), sepsis (OR, 0.63; 95% CI, 0.52-0.75), 3 or more comorbidities (OR, 0.74; 95% CI, 0.68-0.79), and admissions to small (OR, 0.76; 95% CI, 0.64-0.91) or rural (OR, 0.78; 95% CI, 0.65-0.95) hospitals were less likely to undergo same-admission CCY. Conclusions Same-admission CCY should be considered in patients with biliary AP when feasible. This national appraisal recognizes modifiable risk factors to reduce readmission in biliary AP and reinforces adherence to major society guidelines.

Original languageEnglish
Pages (from-to)996-1002
Number of pages7
Issue number8
StatePublished - Sep 1 2018

Bibliographical note

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.


  • Abbreviations
  • acute pancreatitis - AP
  • biliary pancreatitis
  • cholecystectomy
  • cholecystectomy - CCY
  • chronic pancreatitis - CP
  • confidence interval - CI
  • endoscopic retrograde cholangiopancreatography - ERCP
  • gallstone pancreatitis
  • gallstone-induced AP - biliary AP
  • Healthcare Cost Utilization Project - HCUP
  • hospital-acquired conditions - HACs
  • International Classification of Diseases, Ninth Revision, Clinical Modification - ICD-9-CM
  • interquartile range - IQR
  • nationwide readmission
  • Nationwide Readmission Database - NRD
  • odds ratio - OR
  • outcomes
  • State Inpatient Databases - SID

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology


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