Predictive Markers of Surgical Need in Acute Cholecystitis: A Prospective Observational Study

Acute cholecystitis (AC) is a common surgical emergency that can be managed either surgically or conservatively. However, identifying reliable predictors for treatment modalities is crucial in the clinical settings to optimize the patient outcomes. This study aimed to analyze risk factors, clinical presentation, and management modalities in patients with AC.

This prospective observational study conducted over 2 years (January 2023-March 2025) enrolled 100 patients diagnosed with AC. Based on the treatment received, patients were categorized: Surgical (n = 42) and conservative treatment (n = 58) groups. Demographic, clinical, and laboratory data were collected and analyzed. Logistic regression was utilized to evaluate the predictive value of age, body mass index (BMI), leukocyte count, and total bilirubin levels for determining treatment modality and the need for surgery.

The patients were predominantly females (59.0%) and mainly presented with abdominal pain (95.0%) and fever (90.0%). Age and BMI had no significant correlation (r = -0.0346, P = 0.733). The patients with treatment failure had significantly higher mean total bilirubin (P = 0.031) and leukocyte count (P = 0.022) compared to those with treatment success. Age (P = 0.719) and BMI (P = 0.506) were not the significant predictors of treatment modality. However, leukocyte count (P = 0.001) and total bilirubin levels (P = 0.006) were the significant predictors of the need for surgical intervention.

Demographic factors such as age and BMI are not significant predictors of treatment choice in AC, while high leukocyte counts and raised total bilirubin levels are significant predictors of need for surgery.