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Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database

Title: Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database
Authors: Paola Fugazzola; Ahmed Ghaly; Luca Ansaloni; Francesca Dal Mas; Carlo Maria Bianchi; Enrico Cicuttin; Andrea Dagnoni; Simone Frassini; Matteo Tomasoni; Lorenzo Cobianchi; the SPRiMACC Collaborative Group the SPRiMACC Collaborative Group
Source: Medicina ; Volume 61 ; Issue 7 ; Pages: 1228
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: early cholecystectomy (EC); acute calculous cholecystitis (ACC); world society of emergency surgery (WSES); Tokyo guidelines 18 (TG18)
Description: Background and Objectives: Early cholecystectomy (EC) is widely regarded as the first-line treatment for acute calculous cholecystitis (ACC). Current debate centers on the feasibility of EC as an option even for elderly patients. This study aims to determine whether age alone is an independent risk prediction factor for prognosis after EC for ACC. Materials and Methods: This study is a post-hoc analysis of the S.P.Ri.M.A.C.C. WSES prospective international multicenter observational study database, including patients with ACC undergoing EC. Univariate and multivariate analyses were conducted, examining different risk factors for major morbidity and mortality after EC. Results: In the univariate analyses, age was found to be a statistically significant risk factor for both 30-day major complications (p < 0.001) and 30-day mortality (p = 0.003). However, in the multivariate analysis, age alone was not a significant predictor for either outcome, with p-values of 0.419 and 0.094, respectively. The only significant risk factor associated with both 30-day mortality and major morbidity in the multivariate model was the POSSUM Physiological Score (PS). Conclusions: Age alone cannot be considered a reliable risk predictor for a complicated postoperative course after EC in patients with ACC. Frailty, rather than chronological age, should be assessed to predict the outcome of these patients.
Document Type: text
File Description: application/pdf
Language: English
Relation: Surgery; https://dx.doi.org/10.3390/medicina61071228
DOI: 10.3390/medicina61071228
Availability: https://doi.org/10.3390/medicina61071228
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.C7FEDE5F
Database: BASE