1. One-year outcomes of elderly acute cholecystitis patients by index treatment
- Author
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Núria Lluís, Celia Villodre, Lucía Guilabert, Isabel de Castro, Pedro Zapater, Belén Martínez, José R. Aparicio, Fèlix Lluís, and Enrique de-Madaria
- Subjects
cholecystectomy ,laparoscopic ,conservative treatment/methods ,drainage/methods ,endosonography/methods ,propensity score ,Surgery ,RD1-811 - Abstract
BackgroundStrategies for managing the elderly with acute cholecystitis need to be refined.AimsTo examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission.Patients and methodsSingle-institution retrospective study of fifty consecutive patients aged ≥70 years admitted with acute cholecystitis. A propensity score matching analysis adjusted for demographic and clinical variables was carried out.ResultsThe one-year rates of additional procedures were 0%, 47.4%, and 72.7% for surgery, supportive care (SC), and percutaneous gallbladder drainage (PCGD), respectively. The one-year readmission rate was 0%, 15.8%, and 50% after these index procedures, respectively. After propensity score analysis, patients who received SC (55.6% vs. 0%, P = .03) or PCGD (77.8% vs. 0%, P = .002) had a higher rate of additional procedures compared to those who underwent surgery. Additionally, patients receiving PCGD had a higher readmission rate than those undergoing surgery (55.6% vs. 0%, P = .03). Nine patients who received SC and nine patients who received PCGD could have potentially undergone surgery during the index admission. This would have resulted in improved one-year outcomes.ConclusionCholecystectomy during the index hospitalization may provide better one-year outcomes than SC or PCGD in at least 50% of patients ≥70 years with acute cholecystitis.
- Published
- 2025
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