Do I Need to Operate on That in the Middle of the Night? Development of a Nomogram for the Diagnosis of Severe Acute Cholecystitis

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Mattia PortinariSavino Occhionorelli

Abstract

Some authors have proposed different predictive factors of severe acute cholecystitis, but generally, the results of risk analyses are expressed as odds ratios, which makes it difficult to apply in the clinical practice of the acute care surgeon. The severe form of acute cholecystitis should include both gangrenous and phlegmonous cholecystitis, due to their severe clinical course, and cholecystectomy should not be delayed. The aim of this study was to create a nomogram to obtain a graphical tool to compute the probability of having a severe acute cholecystitis. This is a retrospective study on 393 patients who underwent emergency cholecystectomy between January 2010 and December 2015 at the Acute Care Surgery Service of the S. Anna University Hospital of Ferrara, Italy. Patients were classified as having a non-severe acute cholecystitis or a severe acute cholecystitis (i.e., gangrenous and phlegmonous) based on the final pathology report. The baseline characteristics, pre-operative signs, and abdominal ultrasound (US) findings were assessed with a stepwise multivariate logistic regression analysis to predict the risk of severe acute cholecystitis, and a nomogram was created. Age as a continuous variable, WBC count ≥ 12.4 × 103...Continue Reading

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Citations

Jul 8, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Gary Alan BassUNKNOWN European Society for Trauma, Emergency Surgery (ESTES) Cohort Studies Group
Jan 30, 2021·Scientific Reports·Giuseppe Di BuonoAntonino Agrusa
Jul 25, 2020·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Sualeh Muslim KhanMuhammad Sami Khan

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