Clinical characteristics and short‐term outcomes in patients with acute cholecystitis over aged >80 years

Abstract

Aim We investigated the clinical characteristics and short‐term outcomes in acute cholecystitis (AC) patients aged ≥80 years. We therefore sought to determine the ideal treatment for elderly patients with AC. Methods We retrospectively evaluated 253 patients with AC. The patients were divided into two groups according to their age: elderly group (n = 77, aged ≥80 years) and non‐elderly group (n = 176, aged <80 years). We compared the clinical characteristics, in‐hospital mortality and recurrence of cholecystitis within 6 months between the two groups. The predictive factors for in‐hospital mortality were also assessed. Results The elderly group had more severe comorbidities (P = 0.0055), higher severity grade of AC (P = 0.00071) and higher in‐hospital mortality (P = 0.029) than the non‐elderly group. The multivariate analysis showed that the serum creatinine level (hazard ratio 12.43; P = 0.002) was independently associated with the in‐hospital mortality. The elderly group (20.8%) underwent subsequent cholecystectomy less frequently than the non‐elderly group (63.2%; P < 0.0001). The recurrence rate of AC was comparable between the two groups (P = 0.89). The proportion of patients in the elderly group who received percutaneous drainage in the latter period (64.3%) was significantly higher than in the former period (33.3%; P = 0.015). Conclusions More attention should be paid to AC patients with chronic renal disease after treatment. Percutaneous drainage might serve as a definitive treatment without subsequent cholecystectomy in elderly AC patients with various comorbidities. Geriatr Gerontol Int 2019; 19: 208–212.

The Effect of Leucocytosis, Gender Difference, and Ultrasound in the Diagnosis of Acute Cholecystitis in the Elderly Population

“…This data may possibly be the result of delayed hospital admission of elderly people according to many coexisting health and social problems such as lack of health insurance or lack of transport to health care units. Akasu et al reported leucocytosis in patients with acute cholecystitis, but no significant difference between young and elderly groups while Borzellino et al reported leucocytosis in elderly patients with diagnosis of an acute cholecystitis, mean value of 15.6x10 9 /L as more similar to our study [26, 27].…”

Which octogenarian patients are at higher risk after cholecystectomy for symptomatic gallstone disease? A single center cohort study

“…With the aid of modern perioperative care and laparoscopic surgery, patients between 65 and 80 years of age are now thought to have operative risks comparable to the younger population[ 5 ]. To date, the outcomes regarding the safety of cholecystectomy performed in older patients are controversial[ 11 - 13 ].…”