Language-concordant documentation was not significantly associated with LOS, ED revisits, readmission, or surgical follow-up after cholecystectomy

Description #

In LEP cholecystectomy patients, receipt of language-concordant paperwork was not significantly associated with any 30-day postoperative outcome: length of stay (LOS 60.45 vs 50.90 hours, p=0.604), ED revisits (4.3% vs 9.9%, p=0.158), readmission (4.3% vs 4.3%, p=1.000), or surgical follow-up (55.1% vs 49.7%, p=0.454), comparing 69 patients with concordant vs 161 with discordant paperwork (Table 5). These are null/non-significant associations in a study the authors describe as likely underpowered for these infrequent clinical outcomes.

"Interpreter service utilization and language concordant documentation were not significantly associated with LOS, ED visits, hospital readmissions, or surgeon follow-up." (Rosenthal, 2025, p. 1)

"There were no statistically significant differences in postoperative outcomes by use of interpreter services or language concordant paperwork (Table 5)." (Rosenthal, 2025, pp. 3–4)

Methods Context #

What? #ⓘ

The observables: 30-day postoperative LOS (hours), ED re-visits, readmissions, and surgical-team follow-up, compared between patients with language-concordant vs language-discordant paperwork.

"Clinical outcomes were captured if they occurred within 30 days of the operative encounter, and these outcomes included hospital length-of-stay, emergency department (ED) re-visits, readmissions, follow-up visits with the surgical team, and 30-day mortality." (Rosenthal, 2025, p. 2)

How? #ⓘ

Retrospective cohort with univariate analysis; Chi-square for binary outcomes, two-sample t-tests for time-related outcomes, significance at p<0.05.

"Univariate analyses were performed using Chi-square analysis for binary outcomes, two-sample t-tests for time-related outcomes, and univariate regression to determine associations." (Rosenthal, 2025, p. 2)

Who? #ⓘ

228 LEP cholecystectomy patients (69 with language-concordant paperwork vs 161 with discordant paperwork) across five University of Pennsylvania Health System hospitals, Jan 2021–Jan 2024; postoperative events were rare.

"The study population included 228 patients with limited English proficiency who underwent cholecystectomy." (Rosenthal, 2025, p. 2)

Other Notes #

This is the language-concordant-documentation counterpart to the interpreter-use null-association finding; both share the same outcome panel in Table 5.

Caveats #

• Retrospective single-system single-operation design limits generalizability of cholecystectomy language-service findings The study is retrospective and confined to a single health system and a single operation (cholecystectomy), limiting the generalizability of both the utilization rates and the outcome associations. The authors note the multi-hospital, broad-region nature of the system may partly offset this.
• Small sample with rare postoperative events left the cholecystectomy outcome associations underpowered Postoperative events were rare in this relatively small cohort (19 ED visits, 10 readmissions, and 0 deaths among 228 patients), and the authors explicitly attribute the absence of observed mortality to the small sample size. The non-significant associations between language-service use and LOS, ED revisits, readmission, or follow-up therefore cannot be read as evidence of no effect; the study was likely underpowered to detect such differences.