Back to Search
Start Over
Frailty Predicts Morbidity and Mortality After Laparoscopic Cholecystectomy for Acute Cholecystitis: An ACS-NSQIP Cohort Analysis
- Source :
- Journal of Gastrointestinal Surgery
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background Current guidelines recommend laparoscopic cholecystectomy be offered for patients with acute cholecystitis except those deemed as high risk. Few studies have examined the impact of frailty on outcomes for patients undergoing laparoscopic cholecystectomy. Therefore, the aim of this study was to determine the association of frailty with postoperative morbidity and mortality in patients undergoing laparoscopic cholecystectomy for acute cholecystitis. Methods Patients undergoing laparoscopic cholecystectomy for acute cholecystectomy were identified from 2005 to 2010 in the American College of Surgeons National Surgical Quality Improvement Project (NSQIP). The Modified Frailty Index (mFI) was used a surrogate for frailty, and patients were stratified as non-frail (mFI 0), low frailty (mFI 1–2), intermediate frailty (mFI 3–4) and high frailty (mFI ≥ 5). Univariable and multivariable analyses were performed. Receiver operator curves (ROC) and an area under the curve (AUC) were generated to determine accuracy of mFI in predicting postoperative morbidity and mortality. Results Of the 6898 patients undergoing laparoscopic cholecystectomy, 3245 (47%) patients were non-frail. There were 2913 (42%) patients with low-frailty, 649 (9%) patients with intermediate frailty, and 91 (2%) with high frailty. Clavien IV complications were higher for intermediate frail patients (OR 1.81, 95% CI 1.00–3.28, p = 0.050) and high-frail patients (OR 4.59, 95% CI 1.98–10.7, p
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Cholecystitis, Acute
030230 surgery
Cohort Studies
Laparoscopic cholecystectomy
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Internal medicine
medicine
Acute cholecystitis
Humans
In patient
Retrospective Studies
Frailty
business.industry
Gastroenterology
Area under the curve
Quality Improvement
Acs nsqip
Cholecystectomy, Laparoscopic
Outcomes research
030220 oncology & carcinogenesis
Original Article
Surgery
Cholecystectomy
Morbidity
business
Cohort study
Subjects
Details
- ISSN :
- 18734626 and 1091255X
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Gastrointestinal Surgery
- Accession number :
- edsair.doi.dedup.....a38fd4987d680098d3a87aa7e10776b4