Advancing Geriatric Surgical Outcomes in Laparoscopic and Open Cholecystectomy: An American College of Surgeons National Surgical Quality Improvement Program Study of Outcomes.

BackgroundThere is a known correlation with older age and an increase in both postoperative morbidity and mortality in surgery. However, there is limited postoperative data analysis for older patients undergoing cholecystectomy. Our goal was to compare surgical outcomes of cholecystectomy performed in older adults in comparison to younger adults.MethodsThis retrospective cohort study examined patients ages 18 years and older undergoing cholecystectomy from January 2016 to December 2020 from the American College of Surgeons (ACS) National Surgical Quality Improvement Program database. Patients were categorized into 3 age groups: 18-64y, 65-74y, and ≥75y. Thirty-day perioperative outcomes were analyzed using bivariate χ2 test and multivariate logistic regression to estimate the risk of outcomes.ResultsOur study identified 175 512 patients who underwent cholecystectomy: 136 793 (77.9%) patients between 18 and 64y, 25 108 (14.3%) patients between 65 and 74y, and 13 608 (7.8%) ≥75y. Compared with younger adults, patient aged ≥75y were 4.03 times more likely to develop a complication (95% confidence interval [CI]: 3.71-4.39, P < 0.001), 2.84 times more likely to be admitted for any reason (95% CI: 2.64-3.05, P < 0.001), 2.66 times more likely to be readmitted for reasons related to cholecystectomy (95% CI: 2.45-2.9, P < 0.001), and 3.81 times more likely to have an extended hospital stay (95% CI: 3.63-3.99, P < 0.001).ConclusionsThe ≥75y cohort has significantly higher rates of overall complications, higher rates of total and cholecystectomy-related readmissions, and extended length of hospital stay.