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J Korean Soc Emerg Med > Volume 26(4); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(4): 320-325.
응급의료센터로 내원한 급성담낭염 의심환자에서 합병된 급성담낭염 발생의 예측요인 탐색
박홍인1, 박재욱1, 심명보1, 배진건1, 제상모2, 정태녕1, 김의중1, 최성욱1, 김옥준1
1차의과학대학교 분당차병원 응급의학과
2차의과학대학교 분당차병원 소아청소년과
Prediction of Complicated Acute Cholecystitis During Emergency Department Stay
Hong In Park1, Jae Wook Park1, Myung Bo Shim1, Jin Kun Bae1, Sang Mo Je2, Tae Nyoung Chung1, Eui Chung Kim1, Sung Wook Choi1, Ok Jun Kim1
1Department of Emergency Medicine, CHA University Bundang Medical Center, Gyeonggi-do, Korea
2Department of Pediatrics, CHA University Bundang Medical Center, Gyeonggi-do, Korea
Correspondence  Tae Nyoung Chung ,Tel: 031) 780-5843, Fax: 031) 780-5600, Email: hendrix74@cha.ac.kr,
Received: June 11, 2015; Revised: June 16, 2015   Accepted: July 13, 2015.  Published online: August 31, 2015.
ABSTRACT
Purpose:
The aim of the study was to determine the factors associated with complicated acute cholecystitis of initial clinical findings during an emergency department (ED) visit, and to use them as a guideline for consideration of early and active surgical intervention, to improve the prognosis of acute cholecystitis.
Method:
Medical records of adult patients diagnosed and treated in the ED as acute cholecystitis were reviewed retrospectively. Clinical findings including demographic data, past medical history, symptoms, physical exam, and laboratory test results were included in the analysis. A case associated with gall bladder empyema, gangrene, perforation, hydrops, or failure of initial laparoscopic approach was defined as complicated acute cholecystitis. Factors showing significance in univariate analyses were included in binary logistic regression analysis for prediction of complicated acute cholecystitis.
Results:
Age, sex, hypertension history, anorexia, body temperature, white blood cell count (WBC), aspartate aminotransferase, creatinine, total bilirubin, amylase, and lipase were significant in univariate analyses, and included in multivariate analysis. Age (p=0.039), male sex (p=0.004), and WBC (p=0.019) were significant in multivariate analysis.
Conclusion:
Age, sex, and initial WBC of patients diagnosed and treated in the ED as acute cholecystitis were independently associated with complicated acute cholecystitis.
Key words: Acute cholecystitis, Prognosis, Complications
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