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Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Title:	Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study
Authors:	Fugazzola P.; Cobianchi L.; Di Martino M.; Tomasoni M.; Dal Mas F.; Abu-Zidan F. M.; Agnoletti V.; Ceresoli M.; Coccolini F.; Di Saverio S.; Dominioni T.; Farè C. N.; Frassini S.; Gambini G.; Leppäniemi A.; Maestri M.; Martín-Pérez E.; Moore E. E.; Musella V.; Peitzman A. B.; de la Hoz Rodríguez Á.; Sargenti B.; Sartelli M.; Viganò J.; Anderloni A.; Biffl W.; Catena F.; Ansaloni L.; Augustin G.; Moric T.; Awad S.; Alzahrani A. M.; Elbahnasawy M.; Massalou D.; De Simone B.; Demetrashvili Z.; Kimpizi A. D.; Schizas D.; Balalis D.; Tasis N.; Papadoliopoulou M.; Georgios P.; Lasithiotakis K.; Ioannidis O.; Bains L.; Magnoli M.; Cianci P.; Conversano N. I.; Pasculli A.; Andreuccetti J.; Arici E.; Pignata G.; Tiberio G. A. M.; Podda M.; Murru C.; Veroux M.; Distefano C.; Centonze D.; Favi F.; Bova R.; Convertini G.; Balla A.; Sasia D.; Giraudo G.; Gabriele A.; Tartaglia N.; Pavone G.; D’Acapito F.; Fabbri N.; Ferrara F.; Cimbanassi S.; Ferrario L.; Cioffi S.; Fumagalli C.; Degrate L.; Degiuli M.; Sofia S.; Licari L.; Improta M.; Patriti A.; Coletta D.; Conti L.; Malerba M.; Andrea M.; Calabrò M.; De Zolt B.; Bellio G.; Giordano A.; Luppi D.; Corbellini C.; Sampietro G. M.; Marafante C.; Rossi S.; Mingoli A.; Lapolla P.; Cicerchia P. M.; Siragusa L.; Grande M.; Arcudi C.; Antonelli A.
Contributors:	Fugazzola, P.; Cobianchi, L.; Di Martino, M.; Tomasoni, M.; Dal Mas, F.; Abu-Zidan, F. M.; Agnoletti, V.; Ceresoli, M.; Coccolini, F.; Di Saverio, S.; Dominioni, T.; Farè, C. N.; Frassini, S.; Gambini, G.; Leppäniemi, A.; Maestri, M.; Martín-Pérez, E.; Moore, E. E.; Musella, V.; Peitzman, A. B.; de la Hoz Rodríguez, Á.; Sargenti, B.; Sartelli, M.; Viganò, J.; Anderloni, A.; Biffl, W.; Catena, F.; Ansaloni, L.; Augustin, G.; Moric, T.; Awad, S.; Alzahrani, A. M.; Elbahnasawy, M.; Massalou, D.; De Simone, B.; Demetrashvili, Z.; Kimpizi, A. D.; Schizas, D.; Balalis, D.; Tasis, N.; Papadoliopoulou, M.; Georgios, P.; Lasithiotakis, K.; Ioannidis, O.; Bains, L.; Magnoli, M.; Cianci, P.; Conversano, N. I.; Pasculli, A.; Andreuccetti, J.; Arici, E.; Pignata, G.; Tiberio, G. A. M.; Podda, M.; Murru, C.; Veroux, M.; Distefano, C.; Centonze, D.; Favi, F.; Bova, R.; Convertini, G.; Balla, A.; Sasia, D.; Giraudo, G.; Gabriele, A.; Tartaglia, N.; Pavone, G.; D’Acapito, F.; Fabbri, N.; Ferrara, F.; Cimbanassi, S.; Ferrario, L.; Cioffi, S.; Fumagalli, C.; Degrate, L.; Degiuli, M.; Sofia, S.; Licari, L.; Improta, M.; Patriti, A.; Coletta, D.; Conti, L.; Malerba, M.; Andrea, M.; Calabrò, M.; De Zolt, B.; Bellio, G.; Giordano, A.; Luppi, D.; Corbellini, C.; Sampietro, G. M.; Marafante, C.; Rossi, S.; Mingoli, A.; Lapolla, P.; Cicerchia, P. M.; Siragusa, L.; Grande, M.; Arcudi, C.; Antonelli, A.
Publisher Information:	Springer Nature
Publication Year:	2023
Collection:	Sapienza Università di Roma: CINECA IRIS
Subject Terms:	acute cholecystiti; cholecystectomy; POSSUM; surgical risk
Description:	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 < 0.001; 30-day mortality: AUC 0.94, p < 0.001; in-hospital major morbidity: AUC 0.73, p < 0.001; 30-day major morbidity: AUC 0.70, p < 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications. Conclusions: The Chole-risk score was externally validated, but the ...
Document Type:	article in journal/newspaper
Language:	English
Relation:	info:eu-repo/semantics/altIdentifier/pmid/36934276; info:eu-repo/semantics/altIdentifier/wos/WOS:000952262800001; volume:18; numberofpages:12; journal:WORLD JOURNAL OF EMERGENCY SURGERY; https://hdl.handle.net/11573/1679253
DOI:	10.1186/s13017-023-00488-6
Availability:	https://hdl.handle.net/11573/1679253; https://doi.org/10.1186/s13017-023-00488-6
Rights:	info:eu-repo/semantics/openAccess
Accession Number:	edsbas.3C07C236
Database:	BASE