• Yen Chin, Kai-Shan Yang, Shu-Han Chang, Cheng-Chung WeiJamesJDivision of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.Graduate Institute of Integrated Medicine, China Medical, Hei-Tung Yip, Yao-Min Hung, and Renin Chang.
• Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.
• Int. J. Clin. Pract. 2021 Dec 1; 75 (12): e14787.

BackgroundThe current study was designed to investigate the association between cholecystectomy and the risk of non-typhoidal Salmonella (NTS) infection.MethodsWe obtained claims-based data from the Taiwan National Health Insurance Research Database (NHIRD) to perform a nationwide cohort study. A propensity score (PS)-matching analysis was performed with a ratio of 1:2 in the cholecystectomy cohort and cholecystectomy-free group to reduce selection bias. Both groups were followed until NTS diagnosis, a dropout from the insurance programme or the end of 2013. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of NTS infection between the cholecystectomy and cholecystectomy-free groups.ResultsOur study enrolled 197 444 patients who had undergone cholecystectomy and 394 888 patients who did not receive cholecystectomy. The adjusted HR (aHR) of NTS infection was 1.34 (95% CI, 1.13-1.58; P < .001) for the cholecystectomy group after adjusting for demographical characteristics and relevant comorbidities. The study population is predominantly female patients (55%) and older (58% older than 50 years). The subgroup analysis revealed that both sexes and notably, patients aged >50, who underwent cholecystectomy had a higher risk of NTS infection than the matched controls. Follow-up of patients who underwent cholecystectomy showed that they had a significantly higher risk of NTS infection for more than 6 months after the procedure.ConclusionsOur study showed that cholecystectomy might be an independent risk factor for subsequent NTS infection.© 2021 John Wiley & Sons Ltd.

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