{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:49:35Z","timestamp":1779360575994,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009287","name":"NSW Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009287","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009287","name":"NSW Health","doi-asserted-by":"publisher","award":["Translational Research Grant"],"award-info":[{"award-number":["Translational Research Grant"]}],"id":[{"id":"10.13039\/501100009287","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Acute cholecystitis is one of the most common surgical presentations in Australia and increases with age. Guidelines recommend early laparoscopic cholecystectomy (within 7\u00a0days), as it results in shorter length of stay, reduced costs and readmission rates. Despite this, there is a perception that early cholecystectomy may result in higher morbidity and conversion to open surgery in older patients. Our objective is to report the proportion of early versus delayed cholecystectomy in older patients in New South Wales (NSW), Australia, and to compare health outcomes and factors influencing variation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This is a retrospective population\u2010based cohort study of all cholecystectomies for primary acute cholecystitis in NSW residents aged\u2009&gt;50, between 2009 and 2019. The primary outcome was the proportion of early versus delayed cholecystectomy. We used multilevel multivariable logistic regression analyses adjusted for age, sex, comorbidities, insurance status, socio\u2010economic status and hospital characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A high rate (85%) of the 47,478 cholecystectomies in older patients were performed within 7\u00a0days of admission. Delayed surgery was associated with increasing age and comorbidity, male sex, Medicare\u2010only insurance and surgery in low\u2010 or medium\u2010volume centres. Early surgery was associated with shorter overall length of stay, fewer readmissions, less conversion to open surgery and lower bile duct injury rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A high proportion of adults with cholecystitis are undergoing early cholecystectomy in NSW. Our results support the efficacy of early cholecystectomy in older patients and identify potentially modifiable factors relevant to health care professionals and policymakers.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-06968-9","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T13:02:16Z","timestamp":1683118936000},"page":"1704-1710","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Factors Affecting Early Cholecystectomy for Acute Cholecystitis in Older People\u2014A Population\u2010Based Study"],"prefix":"10.1002","volume":"47","author":[{"given":"Jakob K.","family":"K\u00f6stenbauer","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery Royal North Shore Hospital 2065 Sydney NSW Australia"},{"name":"Falls, Balance and Injury Research Centre Neuroscience Research Australia Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Gandy","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital and Community Health Services Sydney NSW Australia"},{"name":"Prince of Wales Clinical School University of New South Wales Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Close","sequence":"additional","affiliation":[{"name":"Falls, Balance and Injury Research Centre Neuroscience Research Australia Sydney NSW Australia"},{"name":"Prince of Wales Clinical School University of New South Wales Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Harvey","sequence":"additional","affiliation":[{"name":"Falls, Balance and Injury Research Centre Neuroscience Research Australia Sydney NSW Australia"},{"name":"University of New South Wales Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005440.pub3"},{"key":"e_1_2_10_3_1","volume-title":"Separation statistics by principal diagnosis in ICD\u201010\u2010AM","author":"Welfare AIoHa","year":"2017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010019\u20100224\u20107"},{"key":"e_1_2_10_5_1","unstructured":"(2017)The second australian atlas of healthcare variation. 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