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- Title
Prediction of Patients with Acute Cholecystitis Requiring Emergent Cholecystectomy: A Simple Score.
- Authors
Yacoub, Wael N.; Petrosyan, Mikael; Sehgal, Indu; Yanling Ma; Chandrasoma, Parakrama; Mason, Rodney J.
- Abstract
The objective was to develop a score, to stratify patients with acute cholecystitis into high, intermediate, or low probability of gangrenous cholecystitis. The probability of gangrenous cholecystitis (score) was derived from a logistic regression of a clinical and pathological review of 245 patients undergoing urgent cholecystectomy. Sixty-eight patients had gangrenous inflammation, 132 acute, and 45 no inflammation. The score comprised of: age > 45 years (1 point), heart rate > 90 beats/min (1 point), male (2 points), Leucocytosis > 13,000/mm3 (1.5 points), and ultrasound gallbladder wall thickness > 4.5mm (1 point). The prevalence of gangrenous cholecystitis was 13% in the low-probability (0-2 points), 33% in the intermediate-probability (2-4.5 points), and 87% in the high probability category (>4.5 points). A cutoff score of 2 identified 31 (69%) patients with no acute inflammation (PPV 90%). This scoring system can prioritize patients for emergent cholecystectomy based on their expected pathology.
- Subjects
CHOLECYSTITIS; LOGISTIC regression analysis; LEUCOCYTOSIS; GALLBLADDER diseases; LEUCOCYTE disorders; GALLBLADDER
- Publication
Gastroenterology Research & Practice, 2010, Vol 2010, p1
- ISSN
1687-6121
- Publication type
Article
- DOI
10.1155/2010/901739