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Updated: Feb 1, 2026

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Pre-surgery age-adjusted Charlson Comorbidity Index is associated with worse outcomes in acute cholecystitis

Aldo Bonaventura1, Irene Leale2, Federico Carbone1

  • 1First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|December 12, 2018
PubMed

Insights

The age-adjusted Charlson Comorbidity Index (CCI) can predict complications in acute cholecystitis (AC) patients undergoing surgery. A CCI score of 5 or higher indicates increased risk for complications, aiding surgical decision-making.

Area of Science:

  • Surgical outcomes
  • Gastroenterology
  • Medical risk assessment

Background:

  • Cholecystectomy is beneficial for acute cholecystitis (AC), but complications can diminish its effectiveness.
  • The age-adjusted Charlson Comorbidity Index (CCI) is used to predict mortality risk.

Purpose of the Study:

  • To determine if the age-adjusted CCI predicts complications in AC patients undergoing cholecystectomy.
  • To assess the association between age-adjusted CCI and hospital stay length.

Main Methods:

  • Retrospective analysis of 271 AC patients from 2005-2013.
  • Evaluation of complications including surgical issues, ICU admission, and in-hospital death.
  • ROC curve analysis to identify CCI cut-off for predicting complications.

Main Results:

  • An age-adjusted CCI cut-off of 5 predicted in-hospital complications (OR 1.35, p=0.035).
  • Surgical complications occurred in 8.5%, ICU admission in 2.2%, and death in 1.5% of patients.
  • No significant association was found between CCI and hospital stay length.

Conclusions:

  • The age-adjusted CCI can be a valuable tool for surgeons managing AC patients.
  • It aids in selecting optimal therapeutic strategies alongside existing risk scores.
  • Predictive value for complications supports its use in surgical decision-making for AC.
Abstract

Keywords:
Acute cholecystitisAge-adjusted Charlson Comorbidity IndexDeathElderly peopleIn-hospital complications

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