Acute Cholecystitis - The Evaluation of Treatment Outcomes and Prognostic Factors
Sina, Jean Antony |
Recenzentas / Reviewer | |
Komisijos pirmininkas / Committee Chairman | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Objective. This study aims to investigate whether the outcome of acute cholecystitis can be predicted by clinical symptoms or specific laboratory data. In this study, the outcomes of different treatment methods for acute cholecystitis will be assessed. Material and methods. The study included 354 patients. After exclusion of patients presenting signs of obstruction or missing clinical data, the study group was reduced to 156 patients, which was separated into two groups: one group of 46 patients treated conservatively and one group 110 of patients treated surgically. The data collected of the 110 patients who were treated surgically were used for discriminant function analysis in order to determine the differences between patients with gangrenous cholecystitis, and those with non-gangrenous acute cholecystitis. The cut-off points for variables were determined by using receiver operating characteristics (ROC) curve analysis and logistic regression was performed to determine the risk of gangrenous cholecystitis. Results. Patients treated conservatively differ from those treated surgically by the mean age of the group and the presence of severe right upper quadrant pain (p-value <0,05). Discriminant function analysis showed that alpha-amylase and alkaline phosphatase (ALP) values were significant discriminators between patients with gangrenous cholecystitis and non-gangrenous acute cholecystitis in the operated population. Cut-off values of 52,5 IU for alpha-amylase and 107,5 IU for ALP were established. The predicted risk of gangrenous cholecystitis is 6,26% if both values are below the respective cut-off values, and 73,03% if both values are above the respective cut-off values. Conclusions. Routine clinical tests help establish the diagnosis of gangrenous cholecystitis. According to our research, we can predict the risk of gangrenous cholecystitis from clinical data.
Šiuo tyrimu siekiama išsiaiškinti, ar ūminio cholecistito gydymo rezultatai galima prognozuoti pagal klinikinius simptomus ar specifinius laboratorinius duomenis. Šiame tyrime bus vertinami skirtingų ūminio cholecistito gydymo metodų rezultatai. Tyrime dalyvavo 354 pacientai. Atmetus pacientus, kuriems pasireiškė obstrukcijos požymių arba trūko klinikinių duomenų, tiriamoji grupė buvo sumažinta iki 156 pacientų, kurie buvo suskirstyti į dvi grupes: vieną grupę sudarė 46 pacientai, gydyti konservatyviai, ir kitą - 110 pacientų, gydytų chirurginiu būdu. Surinkti 110 pacientų, kurie buvo gydomi chirurginiu būdu, duomenys buvo naudojami diskriminantinės funkcijos analizei, siekiant nustatyti skirtumus tarp pacientų, sergančių gangreniniu cholecistitu, ir pacientų, sergančių negangreniniu ūminiu cholecistitu. Įprastiniai klinikiniai tyrimai padeda nustatyti gangreninio cholecistito diagnozę. Mūsų tyrimų duomenimis, iš klinikinių duomenų galime prognozuoti gangreninio cholecistito riziką.