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Incidence and risk factors for hospital-acquired cholecystitis
H Ito1, A Watanabe1, S Okaya1
1Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
Insights
Hospital-acquired cholecystitis (HAC) is common in hospitalized patients. Risk factors include prior cholecystitis, prolonged fasting, and gallstones near the gallbladder neck.
Area of Science:
- Gastroenterology
- Hospital Epidemiology
- Clinical Medicine
Background:
- Acute cholecystitis occurs both in and out of hospital settings.
- Limited data exists on the clinical characteristics of hospital-acquired cholecystitis (HAC).
Purpose of the Study:
- To investigate the clinical characteristics of hospital-acquired cholecystitis (HAC) in a tertiary academic hospital.
Main Methods:
- Retrospective cohort study of hospitalized patients with gallstones but no cholecystitis or cholangitis on admission (January 2018 - December 2021).
- Multivariate logistic regression analysis compared patients with and without HAC.
Main Results:
- Out of 890 patients, 41 (4.6%) developed HAC.
- Independent risk factors for HAC included a history of cholecystitis/cholangitis, fasting for ≥1 day, and gallstones in the gallbladder neck.
- HAC typically manifested weeks after admission, with low rates of bacteremia (9.8%).
Conclusions:
- Hospital-acquired cholecystitis (HAC) is a relatively common complication in hospitalized patients.
- Awareness of HAC is crucial for physicians managing symptomatic hospitalized patients with identified risk factors.
Background:
Acute cholecystitis can occur both inside and outside hospital settings. However, little is known about the clinical characteristics of hospital-acquired cholecystitis (HAC).
Aim:
To investigate the clinical characteristics of HAC in a tertiary academic hospital.
Methods:
This retrospective cohort study included hospitalized patients who were found to have gallstones without cholecystitis or cholangitis on admission between January 2018 and December 2021. Multi-variate logistic regression analysis was used to make comparisons between patients with and without HAC.
Findings:
In total, 890 patients met the inclusion criteria and were evaluated in this study. Forty-one patients (4.6%) developed HAC during the study period. Multi-variate logistic regression analysis showed that a history of cholecystitis or cholangitis, fasting for ≥1 day, and gallstones in the gallbladder neck were independently associated with increased risk of HAC. HAC occurred most frequently after several weeks of admission, and only four patients (9.8%) had bacteraemia.
Conclusions:
HAC was relatively common among hospitalized patients. Physicians should be aware of the possibility of HAC in symptomatic hospitalized patients with certain risk factors.
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