Factors associated with prolonged postoperative hospital stay after cholecystectomy for acute cholecystitis in a Peruvian emergency hospital

Abstract

Background Prolonged postoperative hospital stay after cholecystectomy for acute cholecystitis may reflect baseline vulnerability and disease severity. We assessed preoperative factors associated with prolonged postoperative stay in a Peruvian emergency hospital. Methods We conducted a retrospective cohort study of patients undergoing cholecystectomy for acute cholecystitis in 2024. All potentially eligible source records were screened. Prolonged postoperative stay was defined as >3 days from surgery to discharge. Adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression with robust variance in a prespecified model restricted to preoperative variables. Results Of 540 records screened, 422 patients were eligible. Median postoperative stay was 2.4 days (IQR, 1.0–3.8), and 158 patients (37.4%) stayed >3 days. Higher risk was observed for age 45–64 years (aRR, 1.51; 95% CI, 1.09–2.10), age ≥65 years (aRR, 1.95; 95% CI, 1.37–2.76), diabetes mellitus (aRR, 1.31; 95% CI, 1.02–1.67), and ASA IV–V status (aRR, 1.50; 95% CI, 1.04–2.16). Hypertension and active smoking showed inverse associations and require cautious interpretation. Postoperative complications occurred in 111 patients (26.3%) and were analyzed descriptively. Conclusion Older age, diabetes mellitus, and higher preoperative ASA status were associated with prolonged postoperative stay. These findings warrant prospective validation and should not be interpreted as causal.