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American Journal of Medical Quality
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Postoperative Adverse Events of Cholecystectomy in the Medicare Population

Amy K. Rosen

Health Care Research Unit, Section of General Internal Medicine, Evans Memorial Department of Medicine, Boston University Medical Center, Boston, Massachusetts

Arlene S. Ash

Health Care Research Unit, Section of General Internal Medicine, Evans Memorial Department of Medicine, Boston University Medical Center, Boston, Massachusetts

Jane M. Geraci

Health Care Research Unit, Section of General Internal Medicine, Evans Memorial Department of Medicine, Boston University Medical Center, Boston, Massachusetts, Veterans Affairs Medical Center ( C), Houston, Texas

Ellen P. McCarthy

Health Care Research Unit, Section of General Internal Medicine, Evans Memorial Department of Medicine, Boston University Medical Center, Boston, Massachusetts

Mark A. Moskowitz

Health Care Research Unit, Section of General Internal Medicine, Evans Memorial Department of Medicine, Boston University Medical Center, Boston, Massachusetts

We explored the use of postoperative adverse events of cholecystectomy as possible screens for poor quality of care. Retrospective analysis of clinical data ab stracted from hospital charts between 1985-1986 was conducted on a random sample of 3,182 cholecystectomy cases. Severity of illness models were developed pre dicting adverse events following cholecystectomy in pa tients with and without bile duct exploration. Outcome measures included 17 nonfatal adverse events and death within 30 days of admission. Adverse event rates were 23.2% for cases with bile duct exploration and 14.4% for cases without bile duct exploration. Cross-validated R-squareds and C-statistics showed that models had real, although modest, predictive power. We conclude that clinically meaningful adverse events of cholecystec tomy can be successfully identified through chart ab straction.

American Journal of Medical Quality, Vol. 10, No. 1, 29-37 (1995)
DOI: 10.1177/0885713X9501000106
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