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A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method

It is difficult to differentiate between non-complicated acute cholecystitis (NCAC) and complicated acute cholecystitis (CAC) preoperatively, which are two separate pathologies with different management. The aim of this study was to create an algorithm that distinguishes between CAC and NCAC using t...

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Autores principales: Gojayev, Afig, Karakaya, Emre, Erkent, Murathan, Yücebaş, Sait Can, Aydin, Hüseyin Onur, Kavasoğlu, Lara, Aydoğan, Cem, Yildirim, Sedat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174395/
https://www.ncbi.nlm.nih.gov/pubmed/37171346
http://dx.doi.org/10.1097/MD.0000000000033749
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author Gojayev, Afig
Karakaya, Emre
Erkent, Murathan
Yücebaş, Sait Can
Aydin, Hüseyin Onur
Kavasoğlu, Lara
Aydoğan, Cem
Yildirim, Sedat
author_facet Gojayev, Afig
Karakaya, Emre
Erkent, Murathan
Yücebaş, Sait Can
Aydin, Hüseyin Onur
Kavasoğlu, Lara
Aydoğan, Cem
Yildirim, Sedat
author_sort Gojayev, Afig
collection PubMed
description It is difficult to differentiate between non-complicated acute cholecystitis (NCAC) and complicated acute cholecystitis (CAC) preoperatively, which are two separate pathologies with different management. The aim of this study was to create an algorithm that distinguishes between CAC and NCAC using the decision tree method, which includes simple examinations. In this retrospective study, the patients were divided into 2 groups: CAC (149 patients) and NCAC (885 patients). Parameters such as patient demographic data, American Society of Anesthesiologists (ASA) score, Tokyo grade, comorbidity findings, white blood cell (WBC) count, neutrophil/lymphocyte ratio, C-reactive protein (CRP) level, albumin level, CRP/albumin ratio (CAR), and gallbladder wall thickness (GBWT) were evaluated. In this algorithm, the CRP value became a very important parameter in the distinction between NCAC and CAC. Age was an important predictive factor in patients with CRP levels >57 mg/L, and the critical value for age was 42. After the age factor, the important parameters in the decision tree were WBC and GBWT. In patients with a CRP value of ≤57 mg/L, GBWT is decisive and the critical value is 4.85 mm. Age, neutrophil/lymphocyte ratio, and WBC count were among the other important factors after GBWT. Sex, ASA score, Tokyo grade, comorbidity, CAR, and albumin value did not have an effect on the distinction between NCAC and CAC. In statistical analysis, significant differences were found groups in terms of gender (34.8% vs 51.7% male), ASA score (P < .001), Tokyo grade (P < .001), comorbidity (P < .001), albumin (4 vs 3.4 g/dL), and CAR (2.4 vs 38.4). By means of this algorithm, which includes low-cost examinations, NCAC and CAC distinction can be made easily and quickly within limited possibilities. Preoperative prediction of pathologies that are difficult to manage, such as CAC, can minimize patient morbidity and mortality.
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spelling pubmed-101743952023-05-12 A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method Gojayev, Afig Karakaya, Emre Erkent, Murathan Yücebaş, Sait Can Aydin, Hüseyin Onur Kavasoğlu, Lara Aydoğan, Cem Yildirim, Sedat Medicine (Baltimore) 4500 It is difficult to differentiate between non-complicated acute cholecystitis (NCAC) and complicated acute cholecystitis (CAC) preoperatively, which are two separate pathologies with different management. The aim of this study was to create an algorithm that distinguishes between CAC and NCAC using the decision tree method, which includes simple examinations. In this retrospective study, the patients were divided into 2 groups: CAC (149 patients) and NCAC (885 patients). Parameters such as patient demographic data, American Society of Anesthesiologists (ASA) score, Tokyo grade, comorbidity findings, white blood cell (WBC) count, neutrophil/lymphocyte ratio, C-reactive protein (CRP) level, albumin level, CRP/albumin ratio (CAR), and gallbladder wall thickness (GBWT) were evaluated. In this algorithm, the CRP value became a very important parameter in the distinction between NCAC and CAC. Age was an important predictive factor in patients with CRP levels >57 mg/L, and the critical value for age was 42. After the age factor, the important parameters in the decision tree were WBC and GBWT. In patients with a CRP value of ≤57 mg/L, GBWT is decisive and the critical value is 4.85 mm. Age, neutrophil/lymphocyte ratio, and WBC count were among the other important factors after GBWT. Sex, ASA score, Tokyo grade, comorbidity, CAR, and albumin value did not have an effect on the distinction between NCAC and CAC. In statistical analysis, significant differences were found groups in terms of gender (34.8% vs 51.7% male), ASA score (P < .001), Tokyo grade (P < .001), comorbidity (P < .001), albumin (4 vs 3.4 g/dL), and CAR (2.4 vs 38.4). By means of this algorithm, which includes low-cost examinations, NCAC and CAC distinction can be made easily and quickly within limited possibilities. Preoperative prediction of pathologies that are difficult to manage, such as CAC, can minimize patient morbidity and mortality. Lippincott Williams & Wilkins 2023-05-12 /pmc/articles/PMC10174395/ /pubmed/37171346 http://dx.doi.org/10.1097/MD.0000000000033749 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 4500
Gojayev, Afig
Karakaya, Emre
Erkent, Murathan
Yücebaş, Sait Can
Aydin, Hüseyin Onur
Kavasoğlu, Lara
Aydoğan, Cem
Yildirim, Sedat
A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method
title A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method
title_full A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method
title_fullStr A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method
title_full_unstemmed A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method
title_short A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method
title_sort novel approach to distinguish complicated and non-complicated acute cholecystitis: decision tree method
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174395/
https://www.ncbi.nlm.nih.gov/pubmed/37171346
http://dx.doi.org/10.1097/MD.0000000000033749
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