Potentially preventable causes of mortality in acute calculous cholecystitis: a population-based study

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OBJECTIVE

To analyze potentially preventable causes of mortality from acute calculous cholecystitis (ACC) at the population level.

MATERIAL AND METHODS

A retrospective study of causes of ACC-related mortality was conducted. We used online survey of state hospitals and estimated fatal outcomes following ACC considering appropriate annual e-database.

RESULTS

There were 1.500 deaths among 142.975 patients aged ≥18 years with acute cholecystitis. We received responses to the proposed questionnaire about 1154 deaths (76.9%). Analysis included 648 cases of ACC (K80.0). Mean age of patients was 76.0 years (31—100). There were 256 (39.5%) men and 392 (60.5%) women. ACC severity was assessed according to the Tokyo guidelines (2018). Mild (I) degree was noted in 24 (3.7%) cases, moderate (II) — 270 (41.7%), severe (III) — 354 (54.6%) patients. Cardiovascular diseases and complications caused death in mild ACC regardless of treatment method in 16 (66.7%) cases, in moderate ACC — 106 (39.3%), in severe ACC — 97 (27.4%) cases. ACC caused death in 3 (12.5%) patients with mild disease, 111 (41.1%) with moderate disease and 200 (56.5%) ones with severe disease. Postoperative complications caused death in 4 (16.7%) patients with mild disease, 29 (10.7%) ones with moderate disease and 30 (8.5%) patients with severe disease. Other causes comprised 4.1% (n=1), 8.9% (n=24) and 7.6% (n=27), respectively. Potentially preventable causes of death were identified in 33.0% of cases.

CONCLUSION

ACC-related mortality is mainly associated with comorbidity in elderly and senile patients, late presentation and complicated course of disease. Delayed surgical treatment due to diagnostic and tactical problems, as well as technical intraoperative errors is potentially preventable causes of death.

Keywords:

acute calculous cholecystitis

cholecystectomy

potentially preventable causes of death

Authors:

Revishvili A.Sh.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

ORCID: 0000-0003-1791-9163

Olovyanniy V.E.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

ORCID: 0000-0001-9670-3429

Markov P.V.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0002-9074-5676

Gurmikov B.N.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0001-5958-3608

Kuznetsov A.V.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0002-6696-0499

Received:

08.11.2023

Accepted:

29.12.2023

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