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Acute acalculous cholecystitis in critically ill patients
J Laurila1, H Syrjälä, P A Laurila
1Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Finland. jouko.laurila@pp_fimnet.fi
Acta Anaesthesiologica Scandinavica
|August 19, 2004
Summary
Acute acalculous cholecystitis (AAC) in ICU patients is linked to severe illness and organ failure. Prompt diagnosis and treatment of AAC are crucial for survival in critically ill patients.
Area of Science:
- Critical Care Medicine
- Surgical Gastroenterology
- Intensive Care Unit Management
Background:
- Acute acalculous cholecystitis (AAC) is a severe complication in critically ill patients.
- Understanding AAC's underlying causes, clinical presentation, and outcomes is vital.
Purpose of the Study:
- To evaluate underlying diseases, clinical features, and organ failure severity in operatively treated AAC patients.
- To determine the outcomes of AAC in a mixed intensive care unit (ICU) population.
Main Methods:
- Retrospective analysis of ICU patients with operatively confirmed AAC from 2000-2001.
- Data collected included demographics, diagnoses, APACHE II and SOFA scores, interventions, and outcomes.
Main Results:
- 39 patients (1%) had AAC requiring surgery, most commonly due to infection or cardiovascular surgery.
- Patients had high illness severity (APACHE II=25), frequent organ failure (≥3 organs in 64%), and prolonged ICU stays (mean 19 days).
- Hospital mortality was 44%, significantly higher in patients with greater organ failure (higher SOFA scores).
Conclusions:
- AAC is associated with severe critical illness, infection, multi-organ failure, and extended ICU stays.
- Mortality in AAC is directly related to the severity of organ dysfunction.
- Timely diagnosis and surgical intervention for AAC can be life-saving in critically ill patients.