Gangrenous cholecystitis in male patients: A study of prevalence and predictive risk factors

Carlos Augusto Gomes, Cleber Soares, Salomone Di Saverio, Massimo Sartelli, Poliana Graciele de Souza Silva, Agnes Silva Orlandi, Thais Lacerda Heringer, Felipe Couto Gomes, Fausto Catena, Carlos Augusto Gomes, Cleber Soares, Salomone Di Saverio, Massimo Sartelli, Poliana Graciele de Souza Silva, Agnes Silva Orlandi, Thais Lacerda Heringer, Felipe Couto Gomes, Fausto Catena

Abstract

Backgrounds/aims: The prevalence and risk factors of gangrenous cholecystitis in male are unknown.

Objective: To verify the prevalence and risk factors of gangrenous cholecystitis in males.

Methods: This cross-sectional study includes 95 patients (59.5±17.1 years), with clinical and histopathological diagnosis, operated laparoscopically on 2012-2016. Eligibility was decided based on the variables of age; tachycardia (>100 bpm); leukocytosis (>10,000/mm3); Murphy's sign; gallbladder wall thickness (>4 mm); biochemical tests, morbidities (diabetes, alcoholism, smoking) and mortality. Multivariate regression, the chi-squared and Prevalent Chances Ratio (PCR) were used to define a few parameters.

Results: The prevalence of gangrenous cholecystitis in men older than 50 years was 29.3%. The risk factors for the disease were as follows: diabetes mellitus (p=0.006, RCP=4.191), leukocytosis (p=0.003), gallbladder thickness greater than 4 mm (p=0.035, RCP=3.818), which increased mortality [(p=0.04) (RCP=8.001)]. Murphy's sign showed a negative association (p=0.002, RCP=0.204). Values close to significance were observed in relation to gamma glutamyl transferase (p=0.083, RCP=3.125) and hospital stay (p=0.061, RCP=2.765).

Conclusions: Male gender, and age older than 50 years, were correlated with a high prevalence of necrosis, higher than that reported in females. The risk factors for developing necrosis are the same as those described for female patients.

Keywords: Abdominal infections; Abdominal surgery; Cholecystectomy; Complication; Laparoscopic surgery.

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Source: PubMed

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