APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis

Objective Cholecystostomy is a palliative treatment for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of such patients remains unclear. The Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system is usef...

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Autores principales:	Hua Jiang, Guo Guo, Zhimin Yao, Yuehua Wang
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/26d38790a92c44d68392ee2f48d9d539
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spelling	oai:doaj.org-article:26d38790a92c44d68392ee2f48d9d5392021-12-02T03:03:35ZAPACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis1473-230010.1177/03000605211059288https://doaj.org/article/26d38790a92c44d68392ee2f48d9d5392021-11-01T00:00:00Zhttps://doi.org/10.1177/03000605211059288https://doaj.org/toc/1473-2300Objective Cholecystostomy is a palliative treatment for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of such patients remains unclear. The Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system is useful for estimating the hospital mortality of high-risk patients. We evaluated the therapeutic effect of cholecystostomy by the APACHE IV scoring system in patients aged >65 years with acute cholecystitis. Methods In total, 597 patients aged >65 years with acute cholecystitis were retrospectively analyzed using APACHE IV scores. Results The fitness of the APACHE IV score prediction was good, with an area under the receiver operating characteristic curve of 0.894. The chi square independence test indicated that compared with conservative treatment, cholecystostomy may have different effects on mortality for patients whose estimated mortality rate was >10%. Comparison of the estimated mortality of patients before and after cholecystostomy indicated that the estimated mortality was significantly lower after than before puncture, both in the whole patient group and in the group with an estimated mortality of >10%. Conclusion The APACHE IV scoring system showed that cholecystostomy is a safe and effective treatment for elderly high-risk patients with acute cholecystitis.Hua JiangGuo GuoZhimin YaoYuehua WangSAGE PublishingarticleMedicine (General)R5-920ENJournal of International Medical Research, Vol 49 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Hua Jiang Guo Guo Zhimin Yao Yuehua Wang APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
description	Objective Cholecystostomy is a palliative treatment for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of such patients remains unclear. The Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system is useful for estimating the hospital mortality of high-risk patients. We evaluated the therapeutic effect of cholecystostomy by the APACHE IV scoring system in patients aged >65 years with acute cholecystitis. Methods In total, 597 patients aged >65 years with acute cholecystitis were retrospectively analyzed using APACHE IV scores. Results The fitness of the APACHE IV score prediction was good, with an area under the receiver operating characteristic curve of 0.894. The chi square independence test indicated that compared with conservative treatment, cholecystostomy may have different effects on mortality for patients whose estimated mortality rate was >10%. Comparison of the estimated mortality of patients before and after cholecystostomy indicated that the estimated mortality was significantly lower after than before puncture, both in the whole patient group and in the group with an estimated mortality of >10%. Conclusion The APACHE IV scoring system showed that cholecystostomy is a safe and effective treatment for elderly high-risk patients with acute cholecystitis.
format	article
author	Hua Jiang Guo Guo Zhimin Yao Yuehua Wang
author_facet	Hua Jiang Guo Guo Zhimin Yao Yuehua Wang
author_sort	Hua Jiang
title	APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
title_short	APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
title_full	APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
title_fullStr	APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
title_full_unstemmed	APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
title_sort	apache iv system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/26d38790a92c44d68392ee2f48d9d539
work_keys_str_mv	AT huajiang apacheivsystemhelpstodetermineroleofcholecystostomyinelderlypatientswithacutecholecystitis AT guoguo apacheivsystemhelpstodetermineroleofcholecystostomyinelderlypatientswithacutecholecystitis AT zhiminyao apacheivsystemhelpstodetermineroleofcholecystostomyinelderlypatientswithacutecholecystitis AT yuehuawang apacheivsystemhelpstodetermineroleofcholecystostomyinelderlypatientswithacutecholecystitis
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APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis

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