# One-year outcomes of elderly acute cholecystitis patients by index treatment

## TL;DR

Surgery during initial hospitalization may lead to better outcomes for elderly patients with acute cholecystitis compared to other treatments.

## Contribution

The study compares one-year outcomes of different treatments for elderly acute cholecystitis patients using propensity score matching.

## Key findings

- Surgery had 0% additional procedures compared to 47.4% for supportive care and 72.7% for PCGD.
- Readmission rates were 0% after surgery but 50% after PCGD.
- Nine patients who received SC or PCGD could have potentially benefited from surgery.

## Abstract

Strategies for managing the elderly with acute cholecystitis need to be refined.

To examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission.

Single-institution retrospective study of fifty consecutive patients aged ≥70 years admitted with acute cholecystitis. A propensity score matching analysis adjusted for demographic and clinical variables was carried out.

The one-year rates of additional procedures were 0%, 47.4%, and 72.7% for surgery, supportive care (SC), and percutaneous gallbladder drainage (PCGD), respectively. The one-year readmission rate was 0%, 15.8%, and 50% after these index procedures, respectively. After propensity score analysis, patients who received SC (55.6% vs. 0%, P = .03) or PCGD (77.8% vs. 0%, P = .002) had a higher rate of additional procedures compared to those who underwent surgery. Additionally, patients receiving PCGD had a higher readmission rate than those undergoing surgery (55.6% vs. 0%, P = .03). Nine patients who received SC and nine patients who received PCGD could have potentially undergone surgery during the index admission. This would have resulted in improved one-year outcomes.

Cholecystectomy during the index hospitalization may provide better one-year outcomes than SC or PCGD in at least 50% of patients ≥70 years with acute cholecystitis.