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Pre-surgery age-adjusted Charlson Comorbidity Index is associated with worse outcomes in acute cholecystitis.

Authors :
Bonaventura, Aldo
Leale, Irene
Carbone, Federico
Liberale, Luca
Dallegri, Franco
Montecucco, Fabrizio
Borgonovo, Giacomo
Source :
Digestive & Liver Disease; Jun2019, Vol. 51 Issue 6, p858-863, 6p
Publication Year :
2019

Abstract

Beneficial effects of cholecystectomy in acute cholecystitis (AC) might be weakened by complications. The age-adjusted Charlson Comorbidity Index (CCI) assesses disease relevance in the prediction of one-year mortality. To evaluate whether age-adjusted CCI predicted complications (including surgical complications, intensive care unit [ICU] admission, and in-hospital death) among patients undergoing cholecystectomy for AC. Associations between age-adjusted CCI and the length of hospital stay have been also evaluated. 271 patients were enrolled at Ospedale Policlinico San Martino (Genoa, Italy) between 2005 and 2013. Clinical data and blood samples were collected. Patients' median age was 67 years. They underwent more frequently video-laparoscopic cholecystectomy with a limited rate of conversion to open cholecystectomy. Surgical complications occurred in 23 patients (8.5%). 6 patients (2.2%) needed ICU admission, while death occurred in 4 patients (1.5%). According to the cut-off point identified by ROC curve, an age-adjusted CCI cut-off value of 5 was found predictive for in-hospital complications also when confounders were considered (OR 1.35, 95% CI 1.02–1.79, p = 0.035). No association between adjusted CCI and the length of hospital stay was found. In patients surgically treated for AC, age-adjusted CCI could represent an additional tool, along with available risk scores, to help surgeons in choosing the best therapeutic option. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
15908658
Volume :
51
Issue :
6
Database :
Supplemental Index
Journal :
Digestive & Liver Disease
Publication Type :
Academic Journal
Accession number :
136711955
Full Text :
https://doi.org/10.1016/j.dld.2018.10.002