10 research outputs found
Structure and Polarization Properties of Zn–Nb Films Formed on Steel Sheet by Sputtering
Effects of Small Amounts of Molybdenum, Tungsten, or Tin Additives on the Morphology and Orientation of Electrodeposited Zinc
Effect of a Small Amount of Mo, W and Sn Additives on the Morphology and Orientation of Electrodeposited Zn
Effect of Preadsorption of Polyethylene Glycol on the Appearance and Morphology of Electrogalvanized Steel Sheets
Education and Health among U.S. Working-Age Adults: A Detailed Portrait across the Full Educational Attainment Spectrum
Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients
Background:
Laparoscopic cholecystectomy is commonly performed, and several factors increase the risk of open conversion, prolonging operating time and hospital stay. Preoperative stratification would improve consent, scheduling and identify appropriate training cases. The aim of this study was to develop a validated risk score for conversion for use in clinical practice.
Patients and methods:
Preoperative patient and disease-related variables were identified from a prospective cholecystectomy database (CholeS) of 8820 patients, divided into main and validation sets. Preoperative predictors of conversion were identified by multivariable binary logistic regression. A risk score was developed and validated using a forward stepwise approach.
Results:
Some 297 procedures (3.4%) were converted. The risk score was derived from six significant predictors: age (p = 0.005), sex (p < 0.001), indication for surgery (p < 0.001), ASA (p < 0.001), thick-walled gallbladder (p = 0.040) and CBD diameter (p = 0.004). Testing the score on the validation set yielded an AUROC = 0.766 (p < 0.001), and a score >6 identified patients at high risk of conversion (7.1% vs. 1.2%).
Conclusion:
This validated risk score allows preoperative identification of patients at six-fold increased risk of conversion to open cholecystectomy