TABLE 4.
Adjusted Hazard Ratios for All-Cause Mortality Associated With Bile Duct Injury in Patients Undergoing Cholecystectomy, 2003–2020 (N = 777,486)*,†,‡
| Model 1 | Model 2 | Model 3 | |
|---|---|---|---|
| HR (95% CI) | HR (95% CI) | HR (95% CI) | |
| Bile duct injury‡ | |||
| No | 1.00 | 1.00 | 1.00 |
| Yes | 3.44 (3.02–3.91) | 1.58 (1.39–1.81) | 1.57 (1.38–1.79) |
| Sex | |||
| Female | 1.00 | 1.00 | |
| Male | 1.45 (1.42–1.47) | 1.19 (1.17–1.21) | |
| Age, y | |||
| 18–34 | 1.00 | 1.00 | |
| 35–44 | 1.83 (1.68–1.99) | 1.82 (1.67–1.98) | |
| 45–54 | 4.31 (3.99–4.65) | 4.12 (3.82–4.45) | |
| 55–64 | 10.2 (9.47–11.0) | 8.85 (8.22–9.53) | |
| 65+ | 33.2 (30.9–35.6) | 22.3 (20.8–23.9) | |
| Race/ethnicity | |||
| White | 1.00 | 1.00 | |
| Asian | 0.79 (0.74–0.84) | 0.81 (0.76–0.86) | |
| Black | 1.17 (1.34–1.20) | 1.14 (1.11–1.18) | |
| Hispanic | 0.79 (0.77–0.82) | 0.82 (0.79–0.84) | |
| Missing | 1.13 (1.10–1.16) | 1.16 (1.12–1.19) | |
| Region | |||
| Midwest | 1.00 | 1.00 | |
| Northeast | 1.15 (1.10–1.20) | 1.16 (1.11–1.22) | |
| South | 1.05 (1.03–1.07) | 1.04 (1.02–1.06) | |
| West | 1.06 (1.03–1.08) | 1.05 (1.03–1.07) | |
| Type | |||
| Laparoscopic | 1.00 | 1.00 | |
| Open | 2.13 (2.08–2.18) | 1.98 (1.94–2.02) | |
| Indications for surgery | |||
| Biliary colic | 0.92 (0.90–0.93) | ||
| Cholecystitis | 1.08 (1.04–1.12) | ||
| Other gallbladder disease | 0.98 (0.97–1.00) | ||
| Diseases of the pancreas | 1.21 (1.18–1.23) | ||
| Comorbidities | |||
| Obesity | 0.83 (0.81–0.85) | ||
| Coronary artery disease | 1.63 (1.60–1.66) | ||
| Atrial fibrillation | 1.88 (1.85–1.92) | ||
| Chronic kidney disease | 2.10 (2.06–2.14) | ||
| Chronic liver disease | 1.08 (1.05–1.10) | ||
*Bile duct injuries were identified using CPT codes 47701, 47720, 47721, 47740, 47760, 47765, 47780, 47785, 47790, and 47800.
†All-cause mortality was defined using date of death extracted from National Death Index files.
‡Multivariable Cox proportional hazards regression analysis was used to examine the association between bile duct injury and all-cause mortality among patients who underwent cholecystectomy. The model was simultaneously adjusted for gender, age category, race/ethnicity, procedure type (laparoscopic vs open), and select indications for surgery and comorbidities identified in the 3 years preceding date of surgery.