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[Can mortality in gallstone disease be reduced? An analysis of 1013 patients]
T Bjerkeset1, J O Drogset, M Svinsås
1Kirurgisk avdeling Innherred sykehus, Levanger.
Insights
This study on gallstone disease found that older age and emergency admissions significantly increase mortality risk. Early elective surgery is recommended for elderly patients to reduce lethality.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Geriatric Medicine
Context:
- Gallstone disease affects a significant number of patients, particularly the elderly.
- Retrospective analysis of 1,013 patients over 10 years.
- 49% of patients were admitted as emergencies, highlighting delayed presentation.
Purpose:
- To analyze the relationship between patient demographics, disease characteristics, and outcomes in gallstone disease.
- To evaluate the impact of surgical timing and patient age on mortality.
- To inform clinical practice regarding operative intervention in elderly patients.
Summary:
- Mortality in gallstone disease was 1%, with a significant correlation between advanced age, disease complications, and lethality.
- Patients under 70 years old had no recorded deaths.
- Emergency and delayed operations for acute gallstone disease had higher lethality rates (7%) compared to early planned (0.5%) or elective operations (0.2%).
Impact:
- Advocates for a more liberal approach to elective surgery and early intervention in elderly patients with gallstone disease.
- Suggests that timely surgical management can significantly reduce mortality.
- Highlights the importance of considering patient age and disease severity in treatment planning.
Abstract:
A 10-year retrospective review of 1,013 patients with gallstone disease is analysed. The median age of the patients was 66 (18-100) years. 499 patients (49%) were admitted as emergencies. There was a significant relationship between the patient's age, complicated disease and lethality. The mortality was 1%. No patients below the age of 70 died. There was also a significant relationship between duration of the disease and mortality. Emergency operations and delayed operations for acute disease were encumbered with the highest lethality (7%), while early planned operation for acute disease and elective operations showed a lethality of 0.5 and 0.2% respectively. We advocate a more liberal attitude towards elective operations and early operative intervention in elderly patients who do not respond to medical treatment.