{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T14:04:02Z","timestamp":1762178642114,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["AARF\u201022\u2010974113"],"award-info":[{"award-number":["AARF\u201022\u2010974113"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01AG032952","R01AG062282","R01AG067507","RF1AG083033","U01AG076478"],"award-info":[{"award-number":["P01AG032952","R01AG062282","R01AG067507","RF1AG083033","U01AG076478"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Cholecystectomy is considered the definitive treatment option for cholecystitis, but the effect of different treatment options among people living with dementia (\n PLWD<\/jats:styled-content>\n ) has not been elucidated. This study compares outcomes following cholecystectomy, cholecystostomy tube, and medical management of cholecystitis among this high\u2010risk group.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a retrospective analysis of Medicare claims data 1\/1\/2016 to 12\/31\/2020. The cohort comprised Medicare\n PLWD<\/jats:styled-content>\n aged 66+ admitted to acute care facilities with a new primary diagnosis of cholecystitis. We used inverse propensity weighting regression to adjust for confounding by indication. We compared outcomes during index admission, readmissions, and mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Eight thousand and seven hundred and seventy four individuals met inclusion criteria; 7% open cholecystectomy, 49% minimally invasive (\n MIS<\/jats:styled-content>\n ) cholecystectomy, 13% cholecystostomy tube, 31% managed medically. After adjustment,\n PLWD<\/jats:styled-content>\n undergoing open or\n MIS<\/jats:styled-content>\n cholecystectomy had a greater risk of intensive interventions (Open\n OR<\/jats:styled-content>\n 3.3,\n p<\/jats:italic>\n \u2009<\u20090.001;\n MIS OR<\/jats:styled-content>\n 1.3,\n p<\/jats:italic>\n \u2009=\u20090.02) and surgical complications (Open\n OR<\/jats:styled-content>\n 10.6,\n p<\/jats:italic>\n \u2009<\u20090.001;\n MIS OR<\/jats:styled-content>\n 3.3,\n p<\/jats:italic>\n \u2009<\u20090.001) during the index admission, but a lower risk of readmission (Open\n HR<\/jats:styled-content>\n 0.9,\n p<\/jats:italic>\n \u2009=\u20090.009;\n MIS HR<\/jats:styled-content>\n 0.9,\n p<\/jats:italic>\n \u2009<\u20090.001) and lower mortality (Open\n HR<\/jats:styled-content>\n 0.6,\n p<\/jats:italic>\n \u2009<\u20090.001;\n MIS<\/jats:styled-content>\n 0.6,\n p<\/jats:italic>\n \u2009<\u20090.001) compared with\n PLWD<\/jats:styled-content>\n managed medically.\n PLWD<\/jats:styled-content>\n managed with cholecystostomy tube had no difference in intensive interventions or surgical complications during the index admission, but a higher risk of readmission (\n HR<\/jats:styled-content>\n 1.1,\n p<\/jats:italic>\n \u2009=\u20090.01), cholecystectomy during readmission (\n HR<\/jats:styled-content>\n 1.8,\n p<\/jats:italic>\n \u2009<\u20090.001) and no difference in mortality compared to those managed medically.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Over half of\n PLWD<\/jats:styled-content>\n experiencing acute cholecystitis received definitive surgical treatment during the index admission. Open and\n MIS<\/jats:styled-content>\n cholecystectomy were associated with worse outcomes during the index admission, but reduced mortality and readmissions in the 2\u2009years following index admission. Cholecystostomy tube was associated with a greater likelihood of readmission and subsequent cholecystectomy, and no difference in mortality. These findings should be interpreted within the context of administrative data, which has the potential for selection bias and unmeasured confounding.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.19487","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T03:18:56Z","timestamp":1745291936000},"page":"2088-2096","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cholecystitis Treatment and Outcomes Among People Living With Dementia"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9482-7417","authenticated-orcid":false,"given":"Rachel R.","family":"Adler","sequence":"first","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingwei","family":"Xiang","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6474-1455","authenticated-orcid":false,"given":"Samir K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery University of Florida Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clancy J.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Surgery Virginia Mason Medical Center Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-6087","authenticated-orcid":false,"given":"Zara","family":"Cooper","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Hsu","sequence":"additional","affiliation":[{"name":"Mongan Institute Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Health Care Policy Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart R.","family":"Lipsitz","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel S.","family":"Weissman","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Finlayson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Phillip R. Lee Institute for Health Policy Studies University of California San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.2350"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2009.12.031"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000000668"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182383a78"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010013\u20102924\u20105"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010014\u20103497\u20104"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231175447"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12743"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893\u2010019\u20100548\u2010y"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17183"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2023.05.009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1572\u20100241.2003.04002.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4226"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001767"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.17952"},{"key":"e_1_2_10_17_1","unstructured":"C. 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