REGULAR CONTENT
Final ID
512
Type
Original Scientific Research-Oral or Pos
Authors
J Diamond1, W Adams2, R Mitchell1, P Amin3, C Molvar3, A Malamis3
Institutions
1Loyola University Chicago Stritch School of Medicine, Maywood, IL, 2Loyola University Chicago, Maywood, IL, 3Loyola University Medical Center, Maywood, IL
Purpose
Percutaneous cholecystostomy (PC) can be used to treat cholecystitis in patients who cannot safely undergo immediate cholecystectomy (CCY). PC tube outcomes can be divided into three categories: surgical removal during CCY (SR), non-surgical removal (NSR), and non-removal due to patient death (NRD). Retrospective studies have established that each outcome is equally likely. The purpose of this study is to identify predictors of PC tube outcome, allowing physicians to better manage patient and family expectations.
Materials & Methods
A retrospective study of 137 patients who underwent PC for cholecystitis between 1/2007 and 9/2015 was undertaken. All patients underwent PC because they were poor surgical candidates. A multinomial logistic regression model was used to determine the odds of experiencing a specific outcome as a function of comorbid conditions, admitting diagnoses, ICU status, bile cultures, and the presence of gallstones.
Results
The table below demonstrates that the odds of undergoing NRD vs SR or NSR were significantly increased in patients in the ICU, as well as those with ascites, sepsis, at least one pulmonary comorbidity, or an admitting diagnosis unrelated to cholecystitis. None of these factors significantly altered the odds of undergoing SR vs NSR. Gallstones (p=.36), bile cultures (p=.08), cirrhosis (p=.64), cardiac comorbidity (p=.22), diabetes (p=.63), renal insufficiency (p=.12), and age (p=.87) had no significant impact on outcome.
Conclusions
Patients undergoing PC from the ICU and those with ascites, sepsis, at least one lung comorbidity, or an admitting diagnosis unrelated to cholecystitis are more likely to die before PC tube removal.
Final ID
512
Type
Original Scientific Research-Oral or Pos
Authors
J Diamond1, W Adams2, R Mitchell1, P Amin3, C Molvar3, A Malamis3
Institutions
1Loyola University Chicago Stritch School of Medicine, Maywood, IL, 2Loyola University Chicago, Maywood, IL, 3Loyola University Medical Center, Maywood, IL
Purpose
Percutaneous cholecystostomy (PC) can be used to treat cholecystitis in patients who cannot safely undergo immediate cholecystectomy (CCY). PC tube outcomes can be divided into three categories: surgical removal during CCY (SR), non-surgical removal (NSR), and non-removal due to patient death (NRD). Retrospective studies have established that each outcome is equally likely. The purpose of this study is to identify predictors of PC tube outcome, allowing physicians to better manage patient and family expectations.
Materials & Methods
A retrospective study of 137 patients who underwent PC for cholecystitis between 1/2007 and 9/2015 was undertaken. All patients underwent PC because they were poor surgical candidates. A multinomial logistic regression model was used to determine the odds of experiencing a specific outcome as a function of comorbid conditions, admitting diagnoses, ICU status, bile cultures, and the presence of gallstones.
Results
The table below demonstrates that the odds of undergoing NRD vs SR or NSR were significantly increased in patients in the ICU, as well as those with ascites, sepsis, at least one pulmonary comorbidity, or an admitting diagnosis unrelated to cholecystitis. None of these factors significantly altered the odds of undergoing SR vs NSR. Gallstones (p=.36), bile cultures (p=.08), cirrhosis (p=.64), cardiac comorbidity (p=.22), diabetes (p=.63), renal insufficiency (p=.12), and age (p=.87) had no significant impact on outcome.
Conclusions
Patients undergoing PC from the ICU and those with ascites, sepsis, at least one lung comorbidity, or an admitting diagnosis unrelated to cholecystitis are more likely to die before PC tube removal.