학술논문
Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study
Document Type
article
Author
Paola Fugazzola; Lorenzo Cobianchi; Marcello Di Martino; Matteo Tomasoni; Francesca Dal Mas; Fikri M. Abu-Zidan; Vanni Agnoletti; Marco Ceresoli; Federico Coccolini; Salomone Di Saverio; Tommaso Dominioni; Camilla Nikita Farè; Simone Frassini; Giulia Gambini; Ari Leppäniemi; Marcello Maestri; Elena Martín-Pérez; Ernest E. Moore; Valeria Musella; Andrew B. Peitzman; Ángela de la Hoz Rodríguez; Benedetta Sargenti; Massimo Sartelli; Jacopo Viganò; Andrea Anderloni; Walter Biffl; Fausto Catena; Luca Ansaloni; the S.P.Ri.M.A.C.C. Collaborative Group
Source
World Journal of Emergency Surgery, Vol 18, Iss 1, Pp 1-12 (2023)
Subject
Language
English
ISSN
1749-7922
Abstract
Abstract Background Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. Method The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models—POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade—receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. Results A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p