Evidence map›Paper›PMID 30046948›Full record

ArticleSurgical endoscopy2018

Evolution in the management of acute cholecystitis in the elderly: population-based cohort study.

Tom Wiggins, Sheraz R Markar, Hugh Mackenzie, Sara Jamel, Alan Askari, Omar Faiz, Stavros Karamanakos, George B Hanna

Registry-linked trialOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06601855 (Cholecystectomy Could be Performed in Adults Older Than 80 Years Old With Mild to Moderate Acute Cholecystitis), which is not on this map. Cited by 35 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 4 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06601855 completednot on this map

Cholecystectomy Could be Performed in Adults Older Than 80 Years Old With Mild to Moderate Acute Cholecystitis

TypeobservationalSponsorTaipei Medical University Shuang Ho HospitalRan2018 to 2024Enrolled160ConditionsAcute CholecystitisArmsCholecystectomy
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Tom WigginsDepartment Surgery & Cancer, Imperial College London, London, UK.
Sheraz R MarkarDepartment Surgery & Cancer, Imperial College London, London, UK.
Hugh MackenzieDepartment Surgery & Cancer, Imperial College London, London, UK.
Sara JamelDepartment Surgery & Cancer, Imperial College London, London, UK.
Alan AskariDepartment Surgery & Cancer, Imperial College London, London, UK.
Omar FaizDepartment Surgery & Cancer, Imperial College London, London, UK.
Stavros KaramanakosBasildon University Hospitals NHS Trust, Basildon, UK.
George B HannaDepartment Surgery & Cancer, Imperial College London, London, UK. g.hanna@imperial.ac.uk.
Imperial College London · GBBasildon Hospital · GBSt Mark's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute cholecystitis is a life-threatening emergency in elderly patients. This population-based cohort study aimed to evaluate the commonly used management strategies for elderly patients with acute cholecystitis as well as resulting mortality and re-admission rates.

methodsData from all consecutive elderly patients (≥ 80 years) admitted with acute cholecystitis in England from 1997 to 2012 were captured from the Hospital Episode Statistics database. Influence of management strategies upon mortality was analyzed with adjustment for patient demographics and treatment year.

results47,500 elderly patients were admitted as an emergency with acute cholecystitis. On the index emergency admission the majority of patients (n = 42,620, 89.7%) received conservative treatment, 3539 (7.5%) had cholecystectomy, and 1341 (2.8%) underwent cholecystostomy. In the short term, 30-day mortality was increased in the emergency cholecystectomy group (11.6%) compared to those managed conservatively (9.9%) (p < 0.001). This was offset by the long-term benefits of cholecystectomy with a reduced 1-year mortality [20.8 vs. 27.1% for those managed conservatively (p < 0.001)]. Management with percutaneous cholecystostomy had increased 30-day and 1-year mortality (13.4 and 35.0%, respectively). The annual proportion of cholecystectomies performed laparoscopically increased from 27% in 2006 to 59% in 2012. Within the cholecystectomy group, laparoscopic approach was an independent predictor of reduced 30-day mortality (OR 0.16, 95% CI 0.10-0.25). Following conservative management, there were 16,088 admissions with further cholecystitis. Only 11% of patients initially managed conservatively or with cholecystostomy received subsequent cholecystectomy.

conclusionAcute cholecystitis is associated with significant mortality in elderly patients. Potential benefits of emergency cholecystectomy in selected elderly patients include reduced rate of readmissions and 1-year mortality. Laparoscopic approach for emergency cholecystectomy was associated with an 84% relative risk reduction in 30-day mortality compared to open surgery.

Indexed as

EmergenciesAged, 80 and overCholecystectomy, LaparoscopicCholecystitis, AcuteCholecystostomyConservative TreatmentEnglandFemaleFollow-Up StudiesHumansMaleRetrospective StudiesSurvival RateTreatment OutcomeAcute (MeSH)Aged (MeSH)CholecystitisCholecystitis (MeSH)

Identifiers

PMID30046948
PMCPMC6132885
OpenAlexW2884148971

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.