Ana María Gonzalez Castillo (Barcelona / ES), Julia Seco-Orriols (Barcelona / ES), Maite De Miguel Palacio (Barcelona / ES), Alejandro Bravo Salvà (Barcelona / ES), Amalia Pelegrina Manzano (Barcelona / ES), Estela Membrilla Fernández (Barcelona / ES), Leyre Lorente Poch (Barcelona / ES), Juan Jose Sancho Insenser (Barcelona / ES), Miguel Pera Roman (Barcelona / ES)
Abstract text (incl. references and figure legends)
Introduction: Acute Calculous Cholecystitis (ACC) is the second most frequent surgical condition in emergency departments. There no worldwide consensus on who is the unfit patient for surgery. A recent study identified 4 risk factors that predicts the mortality in a 92% of patients (Acute Cholecystitis Mortality Estimation, ACME).
Methodology: retrospective single-center observational study of 387 adults with ACC during 2 non-consecutive years (2017 and 2019). The primary outcome is to study the prediction of mortality of ACME compared with Tokyo Guidelines 2018 (TG!18) severity classification, ASA and Charlson Comorbidity Index (CCI).
Results: the 89% of the patients had surgical treatment.The mortality was 3.3%; Almost all deaths had ACME, and the mortality without ACME was 0.45%. The punctuation of ACME varies from 0 to 10. A mortality related to ACME"s punctuation varies from 8.6% to 100%. ACME above 1 has a 9,6% of mortality, > 2 points a 10,2%, >3 a 28,1%, >4 a 43,8%, >5 a 66,7%, >6 a 75%, and >7 a 100%. ACME develops the best AUC: 0.96 (0.795-1) comparing to TG18 (AUC 0.896; 0.795-0.996),CCI >5 (AUC 0.789; 0.616-0.962) and ASA >2(AUC 0.792; 0.713-0.871).
Conclusions: ACME is a good and easy tool to predict the mortality in ACC in clinical practice. Its external validation with a prospective multicenter study is now obligatory.
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