One-year outcomes of elderly acute cholecystitis patients by index treatment

BackgroundStrategies for managing the elderly with acute cholecystitis need to be refined.AimsTo examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission.Patients and methodsSingle-institution retrospective study of fifty consecutive patie...

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Main Authors: Núria Lluís, Celia Villodre, Lucía Guilabert, Isabel de Castro, Pedro Zapater, Belén Martínez, José R. Aparicio, Fèlix Lluís, Enrique de-Madaria
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1500700/full
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author Núria Lluís
Celia Villodre
Celia Villodre
Lucía Guilabert
Lucía Guilabert
Isabel de Castro
Isabel de Castro
Pedro Zapater
Pedro Zapater
Pedro Zapater
Pedro Zapater
Belén Martínez
Belén Martínez
José R. Aparicio
José R. Aparicio
Fèlix Lluís
Enrique de-Madaria
Enrique de-Madaria
Enrique de-Madaria
author_facet Núria Lluís
Celia Villodre
Celia Villodre
Lucía Guilabert
Lucía Guilabert
Isabel de Castro
Isabel de Castro
Pedro Zapater
Pedro Zapater
Pedro Zapater
Pedro Zapater
Belén Martínez
Belén Martínez
José R. Aparicio
José R. Aparicio
Fèlix Lluís
Enrique de-Madaria
Enrique de-Madaria
Enrique de-Madaria
author_sort Núria Lluís
collection DOAJ
description BackgroundStrategies for managing the elderly with acute cholecystitis need to be refined.AimsTo examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission.Patients and methodsSingle-institution retrospective study of fifty consecutive patients aged ≥70 years admitted with acute cholecystitis. A propensity score matching analysis adjusted for demographic and clinical variables was carried out.ResultsThe one-year rates of additional procedures were 0%, 47.4%, and 72.7% for surgery, supportive care (SC), and percutaneous gallbladder drainage (PCGD), respectively. The one-year readmission rate was 0%, 15.8%, and 50% after these index procedures, respectively. After propensity score analysis, patients who received SC (55.6% vs. 0%, P = .03) or PCGD (77.8% vs. 0%, P = .002) had a higher rate of additional procedures compared to those who underwent surgery. Additionally, patients receiving PCGD had a higher readmission rate than those undergoing surgery (55.6% vs. 0%, P = .03). Nine patients who received SC and nine patients who received PCGD could have potentially undergone surgery during the index admission. This would have resulted in improved one-year outcomes.ConclusionCholecystectomy during the index hospitalization may provide better one-year outcomes than SC or PCGD in at least 50% of patients ≥70 years with acute cholecystitis.
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spelling doaj-art-549c838a497647eb8b84083b15dfc3d82025-01-30T06:22:09ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011210.3389/fsurg.2025.15007001500700One-year outcomes of elderly acute cholecystitis patients by index treatmentNúria Lluís0Celia Villodre1Celia Villodre2Lucía Guilabert3Lucía Guilabert4Isabel de Castro5Isabel de Castro6Pedro Zapater7Pedro Zapater8Pedro Zapater9Pedro Zapater10Belén Martínez11Belén Martínez12José R. Aparicio13José R. Aparicio14Fèlix Lluís15Enrique de-Madaria16Enrique de-Madaria17Enrique de-Madaria18Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Surgery, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Gastroenterology, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Nursing, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Pharmacology, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Pharmacology, Miguel Hernández University, Elche, SpainIDIBE, CIBERehd, Alicante, SpainDepartment of Gastroenterology, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Gastroenterology, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Gastroenterology, Dr. Balmis General University Hospital, Alicante, SpainAlicante Institute of Health and Biomedical Research (ISABIAL), Alicante, SpainDepartment of Medicine, Miguel Hernández University, Elche, SpainBackgroundStrategies for managing the elderly with acute cholecystitis need to be refined.AimsTo examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission.Patients and methodsSingle-institution retrospective study of fifty consecutive patients aged ≥70 years admitted with acute cholecystitis. A propensity score matching analysis adjusted for demographic and clinical variables was carried out.ResultsThe one-year rates of additional procedures were 0%, 47.4%, and 72.7% for surgery, supportive care (SC), and percutaneous gallbladder drainage (PCGD), respectively. The one-year readmission rate was 0%, 15.8%, and 50% after these index procedures, respectively. After propensity score analysis, patients who received SC (55.6% vs. 0%, P = .03) or PCGD (77.8% vs. 0%, P = .002) had a higher rate of additional procedures compared to those who underwent surgery. Additionally, patients receiving PCGD had a higher readmission rate than those undergoing surgery (55.6% vs. 0%, P = .03). Nine patients who received SC and nine patients who received PCGD could have potentially undergone surgery during the index admission. This would have resulted in improved one-year outcomes.ConclusionCholecystectomy during the index hospitalization may provide better one-year outcomes than SC or PCGD in at least 50% of patients ≥70 years with acute cholecystitis.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1500700/fullcholecystectomylaparoscopicconservative treatment/methodsdrainage/methodsendosonography/methodspropensity score
spellingShingle Núria Lluís
Celia Villodre
Celia Villodre
Lucía Guilabert
Lucía Guilabert
Isabel de Castro
Isabel de Castro
Pedro Zapater
Pedro Zapater
Pedro Zapater
Pedro Zapater
Belén Martínez
Belén Martínez
José R. Aparicio
José R. Aparicio
Fèlix Lluís
Enrique de-Madaria
Enrique de-Madaria
Enrique de-Madaria
One-year outcomes of elderly acute cholecystitis patients by index treatment
Frontiers in Surgery
cholecystectomy
laparoscopic
conservative treatment/methods
drainage/methods
endosonography/methods
propensity score
title One-year outcomes of elderly acute cholecystitis patients by index treatment
title_full One-year outcomes of elderly acute cholecystitis patients by index treatment
title_fullStr One-year outcomes of elderly acute cholecystitis patients by index treatment
title_full_unstemmed One-year outcomes of elderly acute cholecystitis patients by index treatment
title_short One-year outcomes of elderly acute cholecystitis patients by index treatment
title_sort one year outcomes of elderly acute cholecystitis patients by index treatment
topic cholecystectomy
laparoscopic
conservative treatment/methods
drainage/methods
endosonography/methods
propensity score
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1500700/full
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