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Acute cholecystitis in patients with diabetes mellitus - systematic review

100%

Łącka M. , Spychalski P. , Dobrzycka M. , Rostkowska O. , Kobiela J.

European Journal of Translational and Clinical Medicine

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2019

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tom 2

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nr 2

71-79

EN

Introduction According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes Results Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.

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Acute cholecystitis in patients with diabetes mellitus - systematic review

100%

Łącka M. , Spychalski P. , Dobrzycka M. , Rostkowska O. , Kobiela J.

European Journal of Translational and Clinical Medicine

|

2020

|

tom 2

|

nr 2

71-79

EN

Introduction: According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods: This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes. Results: Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions: Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.

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Costs of elective vs emergency cholecystectomy in diabetic patients

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Łącka M. , Spychalski P. , Obłój P. , Łaski D. , Rostkowska O. , Wieszczy P. , Kobiela J.

European Journal of Translational and Clinical Medicine

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2020

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tom 3

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nr 2

37-43

EN

Introduction: Hospitalization costs of diabetic patients are estimated to be higher than non-diabetic. Literature on the topic is however limited. The aim of this study was to compare the costs of elective and emergency cholecystectomy of diabetic and non-diabetic patients. Material and methods: A retrospective analysis involved diabetic versus non-diabetic age- and sex-matched patients who underwent emergency and elective cholecystectomy at a single center in Poland between 2016-2019. Results: The total costs of an elective cholecystectomy were 739.31 ± 423.07 USD for diabetic patients and 797.14 ± 772.24 USD for non-diabetic patients (p = 0.51). Whereas emergency cholecystectomy total costs were 3950.72 ± 2856.83 USD (diabetic patients) and 2464.31 ± 1718.21 USD (non-diabetic patients) (p = 0.04). The difference in total costs between elective cholecystectomy vs emergency cholecystectomy in both groups (diabetic vs non-diabetic patients) was statistically significant (p < 0.01 vs p < 0.05 respectively). Conclusions: In this study we demonstrated that emergency cholecystectomy is associated with a significant increase in hospitalization costs, particularly in diabetic patients. This suggests that early qualification of diabetic patients for an elective cholecystectomy could be beneficial for both diabetic patients and public health insurers.

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Public and private health care services in the opinion of physicians in Poland

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Zgliczyński W. S. , Jankowski M. , Rostkowska O. , Sytnik-Czetwertyński J. , Śliż D. , Karczemna A. , Pinkas J.

International Journal of Occupational Medicine and Environmental Health

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2020

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tom 33

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nr 2

195-214

EN

ObjectivesHealth care services in Poland are delivered by public and private providers. The aims of this study were to assess the attitudes towards private and public health care services in Poland and to identify differences between them, in the opinion of physicians.Material and MethodsA questionnaire-based survey was carried out among physicians attending mandatory courses delivered at the School of Public Health, the Centre of Postgraduate Medical Education in Warsaw, Poland. The questionnaire included 29 questions concerning private and public health care services.ResultsCompleted questionnaires were obtained from 502 physicians (67.7% females), aged 42.1±10.8 years, with a response rate of 77.2%. In the opinion of the surveyed doctors, the major advantages of private health care units, in comparison with public ones, are short waiting times for an appointment (88.2%), an efficient on-site service (78.6%) and convenient appointment times (75.7%). The respondents gave high scores to items such as relations with patients (p < 0.001), superiors (p < 0.001) and colleagues (p = 0.03) when working in private, rather than public, institutions. In the opinion of physicians, public health care institutions guarantee better employment conditions (44.4% vs. 13%; p < 0.001) and security (29.1% vs. 11.1%; p < 0.001) than private ones. The respondents did not observe any differences (p > 0.05) between public and private facilities in terms of the involvement of medical staff and infrastructure. There were significant differences (p < 0.001) in the perception of working conditions in public and private health care institutions depending on the medical education level and the place of primary employment. Conclusions: Among physicians in Poland, private medical institutions are perceived as better organized and granting faster as well as more comprehensive access to health care services when compared to public ones. Closing the gaps between working conditions in public and private units could encourage physicians to practice in the public health care sector.