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The impact of frailty syndrome and risk scores on emergency cholecystectomy patients

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Abstract

Purpose

Cholecystectomy, which is one of the most common surgical procedures, is also performed in the emergency setting. A number of risk scores have been introduced in recent studies; moreover, over the last few years literature has focused on surgical patients with frailty syndrome. The aim of the present study is to evaluate whether frailty syndrome and the risk scores are correlated with morbidity, post-operative hospital stay and the ICU admission rate following emergency cholecystectomy.

Methods

Eighty-five consecutive patients of >65 years of age who underwent cholecystectomy were selected from 2306 emergency procedures for inclusion in the present study. The patients were assessed for frailty syndrome and their scores were calculated on the basis of chart review. Univariate analyses were performed to compare severe frailty patients to intermediate frailty and robust patients. ROC and logistic regression analyses were performed with the end-points of morbidity, hospital stay and ICU admission.

Results

In addition to having worse ASA, inflammatory and risk values than robust patients, frailty syndrome patients also had higher rates of morbidity and ICU admission and longer hospitalization periods. A logistic regression analysis showed that the P-Possum was independently correlated with morbidity. Frailty and open surgery were independently correlated with longer hospitalization, whereas ICU admission was correlated with worse ASA and P-Possum values.

Conclusions

Frailty syndrome significantly impacts the length of hospitalization in patients undergoing emergency cholecystectomy. Although the ORs were limited, the P-Possum value was independently associated with the outcome.

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Acknowledgments

The authors thank Mr Gianluca D’Agostino of the Health Department (Sant’Andrea Hospital, Rome) for his help in database processing and the case-selection analysis.

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Authors and Affiliations

  1. Surgical and Medical Department of Traslational Medicine, University of Rome “La Sapienza”, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy

    Laura Lorenzon, Gianluca Costa, Giulia Massa, Barbara Frezza & Genoveffa Balducci

  2. Health Department, Sant’Andrea Hospital, Rome, Italy

    Francesco Stella

Authors
  1. Laura Lorenzon
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  2. Gianluca Costa
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  3. Giulia Massa
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  4. Barbara Frezza
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  5. Francesco Stella
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  6. Genoveffa Balducci
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Corresponding author

Correspondence to Laura Lorenzon.

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Funding

There are no funding sources to declare.

Conflict of interest

The authors declare no conflicts of interest in association with this manuscript.

Ethical approval/a

All of the procedures in studies involving human participants were performed in accordance with the ethical standards of the institution and were in accordance with the 1964 declaration of Helsinki and its later amendments or comparable ethical standards.

Ethical approval/b

This article does not contain any studies with animals.

Informed consent

Informed consent for the surgical procedures was obtained before treatment from each of the participants who were included in the study.

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Lorenzon, L., Costa, G., Massa, G. et al. The impact of frailty syndrome and risk scores on emergency cholecystectomy patients. Surg Today 47, 74–83 (2017). https://doi.org/10.1007/s00595-016-1361-1

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  • DOI: https://doi.org/10.1007/s00595-016-1361-1

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