Skip to main content

Table 3 Unadjusted and adjusted risk of procedural interventions, post-operative adverse events, and in-hospital post-intervention mortality between urban and rural hospitals for patients admitted with choledocholithiasis and cholangitis

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

Outcome

Unadjusted Risk Rural Hospital

% [95% CI]

Unadjusted Risk Urban Hospital

% [95% CI]

Unadjusted OR

[95% CI]

Unadjusted OR

p-value

Adjusted OR*

[95% CI]

Adjusted OR

p-value

All-cause in-hospital mortality

Choledocholithiasis

0.5 [0.4–0.6]

0.5 [0.5–0.6]

0.99 [0.79–1.24]

0.92

1.24 [0.94–1.64]

0.13

Cholangitis

1.7 [1.1–2.2]

1.7 [1.5–1.9]

1.01 [0.71–1.45]

0.94

1.15 [0.74–1.80]

0.54

Any intervention Δ

Choledocholithiasis

77.5 [76.5–78.5]

90.9 [90.7–91.1]

2.90 [2.72–3.10]

< 0.00001

2.94 [2.72–3.17]

< 0.00001

Cholangitis

27.8 [25.0–30.6]

55.0 [54.1–55.9]

3.17 [2.75–3.66]

< 0.00001

2.97 [2.50–3.54]

< 0.00001

Any surgical intervention

Choledocholithiasis

59.3 [58.2–60.5]

58.4 [57.9–58.8]

0.96 [0.91–1.01]

0.12

0.96 [0.91–1.02]

0.24

Cholangitis

6.7 [5.5–7.8]

7.3 [6.9–7.7]

1.10 [0.91–1.35]

0.32

1.12 [0.89–1.41]

0.34

Any radiologic intervention

Choledocholithiasis

0.7 [0.5–0.8]

1.9 [1.8–2.0]

2.90 [2.35–3.58]

< 0.00001

2.79 [2.20–3.54]

< 0.00001

Cholangitis

1.0 [0.5–1.4]

6.5 [6.1–7.0]

7.26 [4.53–11.63]

< 0.00001

5.78 [3.43–9.74]

< 0.00001

Any endoscopic intervention

Choledocholithiasis

44.8 [43.0–46.7]

75.3 [74.9–75.6]

3.75 [3.47–4.05]

< 0.00001

3.61 [3.33–3.94]

< 0.00001

Cholangitis

23.8 [21.1–26.5]

47.8 [46.8–48.8]

2.93 [2.51–3.43]

< 0.00001

2.79 [2.32–3.36]

< 0.00001

Any post-intervention adverse event

Choledocholithiasis

14.4 [13.8–15.1]

15.3 [15.1–15.5]

1.07 [1.01–1.13]

0.019

1.10 [1.03–1.18]

0.0047

Cholangitis

33.8 [29.5–38.1]

35.4 [34.4–36.4]

1.07 [0.88–1.30]

0.49

1.01 [0.80–1.28]

0.94

Any post-operative complication adverse event

Choledocholithiasis

14.9 [14.1–15.6]

15.9 [15.6–16.1]

1.08 [1.01–1.15]

0.021

1.14 [1.05–1.23]

< 0.001

Cholangitis

40.3 [31.1–49.5]

45.2 [42.6–47.9]

1.22 [0.82–1.82]

0.32

1.10 [0.68–1.77]

0.70

Any post-radiologic complication adverse event

Choledocholithiasis

28.1 [19.3–36.9]

33.1 [31.4–34.9]

1.27 [0.82–1.98]

0.29

1.37 [0.84–2.23]

0.21

Cholangitis

59.7 [39.7–79.7]

47.7 [44.7–50.7]

0.62 [0.27–1.42]

0.26

0.76 [0.28–2.09]

0.60

Any post-endoscopic complication adverse event

Choledocholithiasis

14.1 [13.2–15.0]

15.1 [14.9–15.4]

1.09 [1.01–1.17]

0.028

1.15 [1.05–1.26]

0.0022

Cholangitis

32.5 [27.9–37.1]

33.8 [32.8–34.9]

1.06 [0.86–1.32]

0.57

1.03 [0.80–1.34]

0.79

Any post-intervention mortality

Choledocholithiasis

0.5 [0.4–0.6]

0.5 [0.5–0.5]

1.00 [0.77–1.29]

0.97

1.10 [0.81–1.50]

0.55

Cholangitis

1.5 [0.5–2.5]

1.5 [1.3–1.8]

1.01 [0.51–1.99]

0.98

2.02 [0.71–5.70]

0.19

Post-operative mortality

Choledocholithiasis

0.4 [0.3–0.6]

0.5 [0.4–0.5]

1.05 [0.77–1.45]

0.75

1.19 [0.81–1.74]

0.38

Cholangitis

2.9 [0.1–5.7]

1.9 [1.2–2.6]

0.66 [0.22–1.94]

0.45

4.33 [0.57–32.90]

0.16

Post-radiologic mortality

Choledocholithiasis

4.3 [0.6–8.0]

2.6 [2.0–3.2]

0.60 [0.24–1.52]

0.28

0.65 [0.22–1.86]

0.42

Cholangitis

8.8 [0.0–20.2]*

3.4 [2.4–4.5]

0.37 [0.09–1.62]

0.19

0.92 [0.12–7.20]

0.94

Post-endoscopic mortality

Choledocholithiasis

0.5 [0.3–0.6]

0.4 [0.4–0.5]

0.87 [0.62–1.22]

0.41

0.90 [0.62–1.33]

0.61

Cholangitis

1.4 [0.4–2.4]

1.4 [1.1–1.6]

0.99 [0.46–2.14]

0.98

2.05 [0.61–6.85]

0.24

  1. * Models were adjusted for age category, patient sex, race, insurance status, income quartile, Elixhauser burden category, and weekend hospital admission
  2. Δ Intervention refers to the use of any procedural intervention, including surgery/endoscopy/interventional radiology