Table 1.
Characteristics of patients with gangrenous or non-gangrenous acute cholecystitis
| Characteristics | All patients (n = 290) | Non-gangrenous acute cholecystitis group (n = 184) | Gangrenous cholecystitis group (n = 106) | P-value |
|---|---|---|---|---|
| Male, n (%) | 140 (48%) | 72 (39%) | 68 (64%) | <0.001 |
| Age, years, median (range) | 61 (18–94) | 57 (19–92) | 69 (18–94) | 0.001 |
| BMI, median (range) | 29.5 (16.9–58.3) | 28.7 (17.6–51.7) | 30.0 (16.9–58.3) | 0.836 |
| ASA class, n (%) | 0.076 | |||
| I | 54 (18%) | 38 (21%) | 16 (15%) | |
| II | 158 (55%) | 105 (57%) | 53 (50%) | |
| III | 72 (25%) | 39 (21%) | 33 (31%) | |
| IV | 6 (2%) | 2 (1%) | 4 (4%) | |
| Comorbidity, n (%) | ||||
| Ischaemic heart disease | 40 (14%) | 21 (11%) | 19 (18%) | 0.121 |
| Chronic renal failure | 23 (8%) | 14 (8%) | 9 (9%) | 0.789 |
| Diabetes | 39 (13%) | 19 (10%) | 20 (19%) | 0.040 |
| Chronic liver disease | 10 (3%) | 7 (4%) | 3 (3%) | 0.751 |
| COAD | 18 (6%) | 11 (6%) | 7 (7%) | 0.832 |
| Upper abdominal surgery | 11 (4%) | 7 (4%) | 4 (4%) | 1.000 |
| Smoker, n (%) | 61 (25%) | 43 (27%) | 18 (20%) | 0.214 |
| Glucosteroid use, n (%) | 6 (2%) | 3 (2%) | 3 (3%) | 0.673 |
| Prior biliary colic, n (%) | 141 (53%) | 95 (56%) | 46 (48%) | 0.193 |
| Emergency department referral, n (%) | 260 (90%) | 165 (90%) | 95 (90%) | 0.989 |
| Duration, days, median (range) | ||||
| Symptoms to admission | 1 (0–150) | 1 (0–60) | 1 (0–150) | 0.115 |
| Admission to surgery | 1 (0–14) | 1 (0–10) | 1 (0–14) | 0.029 |
| Vital signs at presentation, n (%) | ||||
| Fever (>38 °C) | 67 (23%) | 29 (16%) | 38 (36%) | <0.001 |
| Tachycardia (HR > 100 bpm) | 61 (21%) | 28 (15%) | 33 (31%) | 0.001 |
| Hypotension (BP < 100 mmHg) | 19 (7%) | 8 (4%) | 11 (10%) | 0.046 |
| Findings at presentation, n (%) | ||||
| Muscular rigidity | 51 (18%) | 22 (12%) | 29 (27%) | 0.001 |
| Murphy's sign positive | 160 (57%) | 94 (54%) | 66 (62%) | 0.161 |
| Laboratory tests, median (range) | ||||
| Haemoglobin, g/l | 140 (90–182) | 140 (90–182) | 143 (100–171) | 0.313 |
| White cell count, ×109/l | 11.7 (1.4–32.4) | 10.7 (3.7–32.4) | 13.4 (1.4–29.0) | <0.001 |
| Platelets, ×109/l | 274 (73–893) | 281 (73–893) | 266 (69–528) | 0.079 |
| CRP, mg/l | 23 (0–500) | 17 (1.0–380) | 94 (0–500) | 0.001 |
| Bilirubin, µmol/l | 18 (5–152) | 17 (5–152) | 19 (8–148) | 0.029 |
| ALT, U/l | 36 (6–1381) | 43 (6–1381) | 26 (10–705) | <0.001 |
| ALP, U/l | 83 (28–487) | 85 (36–487) | 79 (28–234) | 0.061 |
| GGT, U/l | 41 (8–1290) | 50 (8–1290) | 30 (8–666) | <0.001 |
| Albumin, g/l | 39 (19–72) | 39 (19–49) | 39 (20–72) | 0.552 |
| Amylase, U/l | 67 (15–3286) | 64 (15–3286) | 72 (25–615) | 0.158 |
| Lipase, U/l | 24 (10–4270) | 24 (10–4270) | 25 (12–106) | 0.443 |
| Urea, mmol/l | 4.9 (1.5–73) | 4.7 (1.5–73) | 5.3 (1.5–29.8) | 0.016 |
| Creatinine, µmol/l | 77 (49–1070) | 74 (49–394) | 82 (49–1070) | 0.001 |
| Bicarbonate, mmol/l | 26 (17–62) | 26 (17–62) | 26 (17–34) | 0.597 |
| Blood culture positive | 10 (3%) | 6 (3%) | 4 (4%) | 1.000 |
| Radiological investigations, n (%) | ||||
| Ultrasound | ||||
| Diagnosis of acute cholecystitis | 195 (71%) | 113 (65%) | 82 (80%) | 0.012 |
| Gallbladder wall thickening | 189 (69%) | 109 (64%) | 80 (76%) | 0.031 |
| Pericholecystic fluid | 81 (29%) | 46 (26%) | 35 (33%) | 0.188 |
| CBD diameter, mm, median (range) | 6 (1.2–15.0) | 6 (2.0–15.0) | 6 (1.2–12.0) | 0.557 |
| CT diagnostic of cholecystitis, n (%) | 39 (13%) | 24 (13%) | 15 (14%) | 0.790 |
| MRCP diagnostic of cholecystitis, n (%) | 8 (3%) | 4 (2%) | 4 (4%) | 0.471 |
BMI, body mass index; ASA, American Society of Anaesthesiologists; COAD, chronic obstructive airways disease; HR, heart rate; BP, blood pressure; CRP, C-reactive protein; ALT, alanine transaminase; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase; CBD, common bile duct; CT, computed tomography; MRCP, magnetic resonance cholangiopancreatography.
Missing values: BMI, n = 188; smoker, n = 41; glucosteroid use, n = 3; biliary colic history, n = 25; muscle rigidity, n = 1; Murphy's sign positive, n = 9; haemoglobin, n = 2; platelets, n = 3; white cell count, n = 3; CRP, n = 94; bilirubin, n = 5; ALT, n = 8; ALP, n = 5; albumin, n = 6; GGT, n = 6; amylase, n = 235; lipase n = 57; urea, n = 1; creatinine, n = 1; CBD diameter, n = 15; gallbladder thickening, n = 14; pericholecystic fluid, n = 8; MRCP status, n = 1; duration of surgery, n = 1.