One-year outcomes of elderly acute cholecystitis patients by index treatment

Abstract

Background: Strategies for managing the elderly with acute cholecystitis need to be refined. Aims: To examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission. Patients and methods: Single-institution retrospective study of fifty consecutive patients aged ≥70 years admitted with acute cholecystitis. A propensity score matching analysis adjusted for demographic and clinical variables was carried out. Results: The one-year rates of additional procedures were 0%, 47.4%, and 72.7% for surgery, supportive care (SC), and percutaneous gallbladder drainage (PCGD), respectively. The one-year readmission rate was 0%, 15.8%, and 50% after these index procedures, respectively. After propensity score analysis, patients who received SC (55.6% vs. 0%, P =.03) or PCGD (77.8% vs. 0%, P =.002) had a higher rate of additional procedures compared to those who underwent surgery. Additionally, patients receiving PCGD had a higher readmission rate than those undergoing surgery (55.6% vs. 0%, P =.03). Nine patients who received SC and nine patients who received PCGD could have potentially undergone surgery during the index admission. This would have resulted in improved one-year outcomes. Conclusion: Cholecystectomy during the index hospitalization may provide better one-year outcomes than SC or PCGD in at least 50% of patients ≥70 years with acute cholecystitis.