One-year outcomes of elderly acute cholecystitis patients by index treatment.

IF 1.6 4区医学 Q2 SURGERY Frontiers in Surgery Pub Date : 2025-01-30 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1500700

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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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.

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老年急性胆囊炎患者经指数治疗1年疗效观察。

背景：老年人急性胆囊炎的治疗策略需要改进。目的：研究索引入院后一年的附加程序、医院再入院率和门诊访问量。患者和方法：对50例年龄≥70岁的急性胆囊炎患者进行单机构回顾性研究。进行了人口统计学和临床变量调整后的倾向评分匹配分析。结果：手术、支持性护理（SC）和经皮胆囊引流（PCGD）的1年额外手术率分别为0%、47.4%和72.7%。经过这些指标程序后，一年再入院率分别为0%、15.8%和50%。经过倾向评分分析，接受SC （55.6% vs. 0%, P = 0.03）或PCGD （77.8% vs. 0%, P = 0.002）的患者比接受手术的患者有更高的额外手术率。此外，接受PCGD的患者再入院率高于接受手术的患者（55.6%比0%，P = 0.03）。9例接受SC的患者和9例接受PCGD的患者可能在入院时接受手术。这将导致改善一年的结果。结论：对于≥70岁的急性胆囊炎患者，至少50%的患者在住院期间行胆囊切除术可提供比SC或PCGD更好的1年预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

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.