응급의료센터로 내원한 급성담낭염 의심환자에서 합병된 급성담낭염 발생의 예측요인 탐색 (Prediction of Complicated Acute Cholecystitis During Emergency Department Stay)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 26권 / 4호 / 320 ~ 325페이지
· 저자명 : 박홍인, 박재욱, 심명보, 배진건, 제상모, 정태녕, 김의중, 최성욱, 김옥준

초록

Purpose: The aim of the study was to determine the factors associated with complicated acute cholecystitis of initial clinical findings during an emergency department (ED) visit, and to use them as a guideline for consideration of early and active surgical intervention, to improve the prognosis of acute cholecystitis.
Methods: Medical records of adult patients diagnosed and treated in the ED as acute cholecystitis were reviewed retrospectively.
Clinical findings including demographic data, past medical history, symptoms, physical exam, and laboratory test results were included in the analysis. A case associated with gall bladder empyema, gangrene, perforation, hydrops, or failure of initial laparoscopic approach was defined as complicated acute cholecystitis. Factors showing significance in univariate analyses were included in binary logistic regression analysis for prediction of complicated acute cholecystitis.
Results: Age, sex, hypertension history, anorexia, body temperature, white blood cell count (WBC), aspartate aminotransferase, creatinine, total bilirubin, amylase, and lipase were significant in univariate analyses, and included in multivariate analysis. Age (p=0.039), male sex (p=0.004), and WBC (p=0.019) were significant in multivariate analysis.
Conclusion: Age, sex, and initial WBC of patients diagnosed and treated in the ED as acute cholecystitis were independently associated with complicated acute cholecystitis.

영어초록

Purpose: The aim of the study was to determine the factors associated with complicated acute cholecystitis of initial clinical findings during an emergency department (ED) visit, and to use them as a guideline for consideration of early and active surgical intervention, to improve the prognosis of acute cholecystitis.
Methods: Medical records of adult patients diagnosed and treated in the ED as acute cholecystitis were reviewed retrospectively.
Clinical findings including demographic data, past medical history, symptoms, physical exam, and laboratory test results were included in the analysis. A case associated with gall bladder empyema, gangrene, perforation, hydrops, or failure of initial laparoscopic approach was defined as complicated acute cholecystitis. Factors showing significance in univariate analyses were included in binary logistic regression analysis for prediction of complicated acute cholecystitis.
Results: Age, sex, hypertension history, anorexia, body temperature, white blood cell count (WBC), aspartate aminotransferase, creatinine, total bilirubin, amylase, and lipase were significant in univariate analyses, and included in multivariate analysis. Age (p=0.039), male sex (p=0.004), and WBC (p=0.019) were significant in multivariate analysis.
Conclusion: Age, sex, and initial WBC of patients diagnosed and treated in the ED as acute cholecystitis were independently associated with complicated acute cholecystitis.

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