Prediction of Complicated Acute Cholecystitis During Emergency Department Stay.
- Author:
Hong In PARK
1
;
Jae Wook PARK
;
Myung Bo SHIM
;
Jin Kun BAE
;
Sang Mo JE
;
Tae Nyoung CHUNG
;
Eui Chung KIM
;
Sung Wook CHOI
;
Ok Jun KIM
Author Information
1. Department of Emergency Medicine, CHA University Bundang Medical Center, Gyeonggi-do, Korea. hendrix74@cha.ac.kr
- Publication Type:Original Article
- Keywords:
Acute cholecystitis;
Prognosis;
Complications
- MeSH:
Adult;
Amylases;
Anorexia;
Aspartate Aminotransferases;
Bilirubin;
Body Temperature;
Cholecystitis;
Cholecystitis, Acute*;
Creatinine;
Edema;
Emergencies*;
Emergency Service, Hospital*;
Gangrene;
Humans;
Hypertension;
Leukocyte Count;
Lipase;
Logistic Models;
Male;
Medical Records;
Multivariate Analysis;
Prognosis;
Retrospective Studies
- From:Journal of the Korean Society of Emergency Medicine
2015;26(4):320-325
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of the study was to determine the factors associated with complicated acute cholecystitis of initial clinical findings during an emergency department (ED) visit, and to use them as a guideline for consideration of early and active surgical intervention, to improve the prognosis of acute cholecystitis. METHODS: Medical records of adult patients diagnosed and treated in the ED as acute cholecystitis were reviewed retrospectively. Clinical findings including demographic data, past medical history, symptoms, physical exam, and laboratory test results were included in the analysis. A case associated with gall bladder empyema, gangrene, perforation, hydrops, or failure of initial laparoscopic approach was defined as complicated acute cholecystitis. Factors showing significance in univariate analyses were included in binary logistic regression analysis for prediction of complicated acute cholecystitis. RESULTS: Age, sex, hypertension history, anorexia, body temperature, white blood cell count (WBC), aspartate aminotransferase, creatinine, total bilirubin, amylase, and lipase were significant in univariate analyses, and included in multivariate analysis. Age (p=0.039), male sex (p=0.004), and WBC (p=0.019) were significant in multivariate analysis. CONCLUSION: Age, sex, and initial WBC of patients diagnosed and treated in the ED as acute cholecystitis were independently associated with complicated acute cholecystitis.
