ArticleWorld journal of emergency surgery : WJES2021
Mortality risk estimation in acute calculous cholecystitis: beyond the Tokyo Guidelines.
Article in World journal of emergency surgery : WJES, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04744441 (Mortality Risk Estimation in Acute Calculous Cholecystitis), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
Mortality Risk Estimation in Acute Calculous Cholecystitis: Beyond the Tokyo Guidelines
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Unveiling the therapeutic role of Dachaihu decoction in acute cholecystitis: a comprehensive systematic review and meta-analysis of its efficacy and safety.Frontiers in pharmacology · 2024Pooled it
- Association between triglyceride glucose index-related indices with gallbladder disease: a prospective cohort study in rural China.Scientific reports · 2025Article
- The Microbiological Spectrum and Antibiotic Resistance in Acute Acalculous and Calculous Cholecystitis: A Seven-Year Study in a Tertiary Center.Medicina (Kaunas, Lithuania) · 2025Article
- Review
- The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach.Journal of clinical medicine · 2024Review
- Impact of empiric antibiotic therapy on the clinical outcome of acute calculous cholecystitis.Langenbeck's archives of surgery · 2023Observational
- The Association of Polish Surgeons (APS) clinical guidelines for the use of laparoscopy in the management of abdominal emergencies. Part I.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023Article
- Acute Cholecystitis Presenting With Atypical Radiologic or Laboratory Findings: A Case Report.Cureus · 2023Article
- Article
- Correlation of Inpatients Suffering from Acute Acalculous Cholecystitis during ICU Treatment with Acute Physiology and Chronic Health Evaluation II Score, Duration of Ventilator Use, and Time on Total Parenteral Nutrition.Computational and mathematical methods in medicine · 2022Article
- Clinical evolution of gallstones following percutaneous cholecystostomy in patients with severe acute calculous cholecystitis: a single-center analysis of 102 cases.Annals of gastroenterologyArticle
- The i-EUS consensus on EUS-guided gallbladder drainage: A 3-step modified Delphi approach.Endoscopic ultrasoundArticle
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute calculous cholecystitis (ACC) is the second most frequent surgical condition in emergency departments. The recommended treatment is the early laparoscopic cholecystectomy; however, the Tokyo Guidelines (TG) advocate for different initial treatments in some subgroups of patients without a strong evidence that all patients will benefit from them. There is no clear consensus in the literature about who is the unfit patient for surgical treatment. The primary aim of the study is to identify the risk factors for mortality in ACC and compare them with Tokyo Guidelines (TG) classification.
methodsRetrospective unicentric cohort study of patients emergently admitted with and ACC during 1 January 2011 to 31 December 2016. The study comprised 963 patients. Primary outcome was the mortality after the diagnosis. A propensity score method was used to avoid confounding factors comparing surgical treatment and non-surgical treatment.
resultsThe overall mortality was 3.6%. Mortality was associated with older age (68 + IQR 27 vs. 83 + IQR 5.5; P = 0.001) and higher Charlson Comorbidity Index (3.5 + 5.3 vs. 0+2; P = 0.001). A logistic regression model isolated four mortality risk factors (ACME): chronic obstructive pulmonary disease (OR 4.66 95% CI 1.7-12.8 P = 0.001), dementia (OR 4.12; 95% CI 1.34-12.7, P = 0.001), age > 80 years (OR 1.12: 95% CI 1.02-1.21, P = 0.001) and the need of preoperative vasoactive amines (OR 9.9: 95% CI 3.5-28.3, P = 0.001) which predicted the mortality in a 92% of the patients. The receiver operating characteristic curve yielded an area of 88% significantly higher that 68% (P = 0.003) from the TG classification. When comparing subgroups selected using propensity score matching with the same morbidity and severity of ACC, mortality was higher in the non-surgical treatment group. (26.2% vs. 10.5%).
conclusionsMortality was higher in ACC patients treated with non-surgical treatment. ACME identifies high-risk patients. The validation to ACME with a prospective multicenter study population could allow us to create a new alternative guideline to TG for treating ACC.
trial registrationRetrospectively registered and recorded in Clinical Trials. NCT04744441.
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