# The Risk Factor Analysis of Gallbladder Gangrene in Acute Acalculous Cholecystitis: A Single-Center Retrospective Study

## TL;DR

This study identifies risk factors and a new predictive marker for gallbladder gangrene in a specific type of gallbladder inflammation.

## Contribution

The systemic immune-inflammation index (SII) is shown to be a novel and effective predictor of gallbladder gangrene.

## Key findings

- Gallbladder gangrene occurred in 45.1% of acute acalculous cholecystitis patients.
- SII outperformed other inflammatory markers in predicting gangrenous cholecystitis.
- Platelet, PCT, SII, D-dimer, CA19-9, gallbladder enlargement, and effusion are independent risk factors.

## Abstract

This research was performed to determine the risk factors for gallbladder gangrene in acute acalculous cholecystitis patients and to assess the predictive ability of inflammatory markers.

The study included 226 acute acalculous cholecystitis patients who underwent laparoscopic cholecystectomy within 72 h of onset. The receiver operating characteristic curves were employed to determine the optimal cut-off, specificity, and sensitivity of inflammatory markers in predicting gangrenous cholecystitis. Logistic regression analysis was conducted to ascertain the independent risk factors associated with gallbladder gangrene.

The incidence rate of gallbladder gangrene in acute acalculous cholecystitis was 45.1% (102/226). Compared with other inflammatory markers, the systemic immune-inflammation index (SII) demonstrated superior predictive validity (vs. CRP, p = 0.021; vs. WBC, p < 0.001; vs. PCT, p = 0.004; vs. NLR, p < 0.001; vs. PLR, p < 0.001). The results of the logistic regression analysis revealed that platelet, PCT, SII, D-dimer, CA19-9, gallbladder enlargement, and gallbladder effusion were independent risk factors.

This study found that platelet, PCT, SII, D-dimer, CA19-9, gallbladder enlargement, and gallbladder effusion were independent risk factors for gallbladder gangrene in acute acalculous cholecystitis. SII could serve as a novel, straightforward, and potent predictive indicator for gallbladder gangrene in acute acalculous cholecystitis.