Núria Lluís, Celia Villodre, Lucía Guilabert, Isabel de Castro, Pedro Zapater, Belén Martínez, José R Aparicio, Fèlix Lluís, Enrique de-Madaria
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引用次数: 0
Abstract
Background: Strategies for managing the elderly with acute cholecystitis need to be refined.
Aims: To examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission.
Patients and methods: Single-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.
Results: The 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.
Conclusion: Cholecystectomy 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.
期刊介绍:
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.