Abu-Zidan, Fikri M

Agnoletti, Vanni

Anderloni, Andrea

Ansaloni, Luca

Biffl, Walter

Catena, Fausto

Ceresoli, Marco

Cobianchi, Lorenzo

Coccolini, Federico

Dal Mas, Francesca

de la Hoz Rodríguez, Ángela

Di Martino, Marcello

Di Saverio, Salomone

Dominioni, Tommaso

Farè, Camilla Nikita

Frassini, Simone

Fugazzola, Paola

Gambini, Giulia

Leppäniemi, Ari

Maestri, Marcello

Martín-Pérez, Elena

Moore, Ernest E

Musella, Valeria

Peitzman, Andrew B

S.P.Ri.M.A.C.C. Collaborative Group

Sargenti, Benedetta

Sartelli, Massimo

Tomasoni, Matteo

Viganò, Jacopo

World Journal of Emergency Surgery

English

Background: Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. Method: The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. Results: A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p < 0.001; 30-day mortality: AUC 0.94, p < 0.001; in-hospital major morbidity: AUC 0.73, p < 0.001; 30-day major morbidity: AUC 0.70, p < 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications. Conclusions: The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action. Trial registration: ClinicalTrial.gov NCT04995380

Farè, Camilla Nikita

Leppäniemi, Ari

Martín-Pérez, Elena

de la Hoz Rodríguez, Ángela

Viganò, Jacopo

Archivio Istituzionale della Ricerca - Università degli Studi di Pavia

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Fugazzola, Paola J.

Abu-Zidan, Fikri

Fare, Camilla Nikita

Martin-Perez, Elena

Moore, Ernest

Peitzman, Andrew

Rodriguez, Angela de la Hoz

Vigano, Jacopo

Helsingin yliopiston digitaalinen arkisto

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis : results of the SPRi.MACC study

BackgroundLess invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models.MethodThe S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities.ResultsA 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p < 0.001; 30-day mortality: AUC 0.94, p < 0.001; in-hospital major morbidity: AUC 0.73, p < 0.001; 30-day major morbidity: AUC 0.70, p < 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications.ConclusionsThe Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action.Trial Registration: ClinicalTrial.gov NCT04995380

Leppaniemi, Ari

BÜYÜKKASAP, AHMET ÇAĞRI

Gazi University Research Information System

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the SPRi.MACC study

20.500.12530/87885Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p  The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action. ClinicalTrial.gov NCT04995380

RIMASaud Institutional Repository of the Regional Health System

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study.

BackgroundLess invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models.MethodThe S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities.ResultsA 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p &lt; 0.001; 30-day mortality: AUC 0.94, p &lt; 0.001; in-hospital major morbidity: AUC 0.73, p &lt; 0.001; 30-day major morbidity: AUC 0.70, p &lt; 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications.ConclusionsThe Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action.Trial Registration: ClinicalTrial.gov NCT04995380

Archivio della Ricerca - Università di Pisa

Background
Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models.

Method
The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models—POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade—receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities.

Results
A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p &lt; 0.001; 30-day mortality: AUC 0.94, p &lt; 0.001; in-hospital major morbidity: AUC 0.73, p &lt; 0.001; 30-day major morbidity: AUC 0.70, p &lt; 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a ‘Chole-POSSUM’ score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96–97% negative predictive value for major complications.

Conclusions
The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action

Archivio istituzionale della ricerca - Università degli Studi di Venezia Ca' Foscari

BACKGROUND: Less invasive alternatives than early cholecystectomy
(EC) for acute calculous cholecystitis (ACC) treatment have been
spreading in recent years. We still lack a reliable tool to
select high-risk patients who could benefit from these
alternatives. Our study aimed to prospectively validate the
Chole-risk score in predicting postoperative complications in
patients undergoing EC for ACC compared with other preoperative
risk prediction models. METHOD: The S.P.Ri.M.A.C.C. study is a
World Society of Emergency Surgery prospective multicenter
observational study. From 1st September 2021 to 1st September
2022, 1253 consecutive patients admitted in 79 centers were
included. The inclusion criteria were a diagnosis of ACC and to
be a candidate for EC. A Cochran-Armitage test of the trend was
run to determine whether a linear correlation existed between the
Chole-risk score and a complicated postoperative course. To
assess the accuracy of the analyzed prediction models-POSSUM
Physiological Score (PS), modified Frailty Index, Charlson
Comorbidity Index, American Society of Anesthesiologist score
(ASA), APACHE II score, and ACC severity grade-receiver operating
characteristic (ROC) curves were generated. The area under the
ROC curve (AUC) was used to compare the diagnostic abilities.
RESULTS: A 30-day major morbidity of 6.6\% and 30-day mortality
of 1.1\% were found. Chole-risk was validated, but POSSUM PS was
the best risk prediction model for a complicated course after EC
for ACC (in-hospital mortality: AUC 0.94, p &lt; 0.001; 30-day
mortality: AUC 0.94, p &lt; 0.001; in-hospital major morbidity: AUC
0.73, p &lt; 0.001; 30-day major morbidity: AUC 0.70, p &lt; 0.001).
POSSUM PS with a cutoff of 25 (defined in our study as a
'Chole-POSSUM' score) was then validated in a separate cohort of
patients. It showed a 100\% sensitivity and a 100\% negative
predictive value for mortality and a 96-97\% negative predictive
value for major complications. CONCLUSIONS: The Chole-risk score
was externally validated, but the CHOLE-POSSUM stands as a more
accurate prediction model. CHOLE-POSSUM is a reliable tool to
stratify patients with ACC into a low-risk group that may
represent a safe EC candidate, and a high-risk group, where new
minimally invasive endoscopic techniques may find the most useful
field of action. TRIAL REGISTRATION: ClinicalTrial.gov
NCT04995380

Paola Fugazzola

Lorenzo Cobianchi

Marcello Di Martino

Matteo Tomasoni

Francesca Dal Mas

Fikri M. Abu-Zidan

Vanni Agnoletti

Marco Ceresoli

Federico Coccolini

Salomone Di Saverio

Tommaso Dominioni

Camilla Nikita Farè

Simone Frassini

Giulia Gambini

Ari Leppäniemi

Marcello Maestri

Elena Martín-Pérez

Ernest E. Moore

Valeria Musella

Andrew B. Peitzman

Ángela de la Hoz Rodríguez

Benedetta Sargenti

Massimo Sartelli

Jacopo Viganò

Andrea Anderloni

Walter Biffl

Fausto Catena

Luca Ansaloni

the S. P. Ri. M. A. C. C. Collaborative Group

Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

Prediction of morbidity and mortality after early cholecystectomy
for acute calculous cholecystitis: results of the
{S.P.Ri.M.A.C.C}. study

https://helda.helsinki.fi/bitstream/10138/357141/1/s13017_023_00488_6.pdf

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis : results of the SPRi.MACC study

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