Akut kolesistitte konservatif tedavi sonrası interval kolesistektomi bekleyen hastalarda erken yeniden yatışın prediktörleri: Retrospektif kohort çalışması

Öz

Amaç: Akut kolesistit tedavisinde interval kolesistektomi yaygın bir strateji olmasına rağmen, bekleme döneminde hastaların önemli bir kısmı komplikasyonlar nedeniyle yeniden hastaneye yatmaktadır. Bu çalışma, konservatif tedavi sonrası interval kolesistektomi planlanan hastalarda erken yeniden yatışı etkileyen faktörleri belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif kohort çalışmasında, Ocak 2023-Aralık 2024 tarihleri arasında akut kolesistit tanısıyla yatırılarak konservatif tedavi uygulanan ve interval kolesistektomi planlanan hastalar değerlendirildi. Hastalar, taburculuk sonrası altı hafta içinde yeniden başvurup başvurmamalarına göre Erken Başvuru Grubu (EBG) ve Normal Başvuru Grubu (NBG) olarak sınıflandırıldı. Demografik, klinik ve laboratuvar verileri karşılaştırıldı; risk faktörleri lojistik regresyon analizi ile değerlendirildi. Bulgular: Çalışmaya 110 hasta dahil edildi (NBG= 78, EBG= 32). Çok değişkenli analizde erkek cinsiyet (OR: 5,108; %95 GA: 1,758-14,852; p=0,003) ve diyabetes mellitus (OR: 8,521; %95 GA: 2,933-24,756; p<0,001) erken yeniden yatış için bağımsız prediktörler olarak saptandı. Yaş, inflamatuar belirteçler ve safra kesesi taşı boyutu anlamlı ilişki göstermedi (p>0.05). Sonuç: Erkek cinsiyet ve diyabetes mellitus, interval kolesistektomi bekleyen hastalarda erken yeniden yatış için bağımsız risk faktörleridir. Bu risk faktörlerine sahip hastalarda uzun süreli konservatif tedavi yerine erken cerrahi müdahale düşünülmelidir.

Anahtar Kelimeler

• Akut kolesistit
• kolesistektomi
• hasta yeniden yatışı
• diyabetes mellitus
• risk faktörleri

Predictors of early readmission in patients awaiting interval cholecystectomy after conservative treatment of acute cholecystitis: A retrospective cohort study

Öz

Aim: Although interval cholecystectomy is a common strategy in the treatment of acute cholecystitis, a significant proportion of patients are readmitted due to complications during the waiting period. This study aims to identify factors affecting early readmission in patients scheduled for interval cholecystectomy after conservative treatment. Material and Methods: In this retrospective cohort study, patients hospitalized with acute cholecystitis between January 2023 and December 2024 who received conservative treatment and were scheduled for interval cholecystectomy were evaluated. Patients were classified as Early Presentation Group (EPG) and Normal Presentation Group (NPG) based on whether they were readmitted within six weeks after discharge. Demographic, clinical, and laboratory data were compared; risk factors were evaluated by logistic regression analysis. Results: A total of 110 patients were included in the study (NPG: 78, EPG: 32). In multivariate analysis, male gender (OR: 5.108; 95% CI: 1.758-14.852; p=0.003) and diabetes mellitus (OR: 8.521; 95% CI: 2.933-24.756; p<0.001) were identified as independent predictors of early readmission. Age, inflammatory markers, and gallbladder stone size showed no significant association. Conclusion: Male gender and diabetes mellitus are independent risk factors for early readmission in patients awaiting interval cholecystectomy. Early surgical intervention should be considered instead of prolonged conservative treatment in patients with these risk factors.

Anahtar Kelimeler

• Acute cholecystitis
• cholecystectomy
• patient readmission
• diabetes mellitus
• risk factors

Kaynakça

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