Independent Predictors of Extended Hospitalization Following Cholecystectomy: A Multivariate Analysis

Introduction: Cholecystectomy, the surgical removal of the gallbladder, is one of the most commonly performed surgical procedures worldwide, particularly in patients with symptomatic cholelithiasis and cholecystitis. This study aimed to assess the independent predictors of extended hospitalization following cholecystectomy. Methods: This prospective observational study was conducted at the various surgical units of the inpatient Department of Surgery, Dhaka Medical College Hospital, Dhaka, from July 2018 to June 2019. Patients with cholecystitis attending in the outdoor or emergency, admitted with cholecystitis in Dhaka Medical College Hospital, Dhaka were considered as the study population. A total of 50 patients were selected as study subjects by purposive sampling technique. Statistical Package for Social Science (SPSS) version 21 for Windows was used to analyze the data. A p-value < 0.05 was considered to be significant. Result: The median length of stay (LOS) was 5.0 days (range: 1–21 days), with the 80th percentile at 6 days. Patients were classified into two groups: control (LOS <6 days) and prolonged LOS (≥6 days). Univariate analysis revealed that factors such as patient age (p <0.002), male gender (p =0.026), preoperative leukocyte count (p =0.002), preoperative NLR (p <0.002), and admission through the ED (p <0.002) were linked to prolonged LOS. Multivariate analysis identified three independent predictors of prolonged LOS: age ≥50 years (OR 2.212, 95% CI 1.372 – 3.530, p <0.002), preoperative NLR ≥3.0 (OR 1.776, 95% CI 1.146–2.725, p =0.004), and admission via the ED (OR 1.664, 95% CI 1.070–2.560, p =0.008). Conclusion: This study identifies key independent predictors of extended hospitalization (≥6 days) following cholecystectomy, highlighting the roles of advanced age (≥50 years), elevated neutrophil-lymphocyte ratio (NLR ≥3), and admission through the emergency department (ED). Through multivariate analysis, these factors were shown ...