PDF(Pubmed)
Abstract：
A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis.
The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO.
This is a post hoc study of the SPRiMACC study. It´s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC.
1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC.
Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.
The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO.
This is a post hoc study of the SPRiMACC study. It´s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC.
1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC.
Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.
摘要：
背景：教科书结局患者是指手术过程顺利通过的患者，无并发症,再入院或死亡。缺乏关于急性胆囊炎的TO方面的出版物。
目的：本研究的目的是分析急性胆囊炎紧急早期胆囊切除术（UEC）患者的TO成就。并确定哪些因素与实现TO相关。
方法：这是SPRiMACC研究的事后研究。这是一项由WSES进行的前瞻性多中心观察性研究。在紧急早期胆囊切除术（TOUEC）中定义TO的标准是无30天死亡率，无术后30天并发症,30天内没有再入院，住院时间≤7天（第75百分位数），和全腹腔镜手术。满足所有这些条件的患者被视为呈现TOUEC。
结果：1246例紧急早期胆囊切除术治疗ACC。总之,789名患者（63.3%）达到所有TOUEC参数，而457（36.6％）未能达到一个或多个参数，被认为是非TOUEC。在所有分析的风险量表上，达到TOUEC的患者更年轻，得分明显较低。在血清学测试中，TOUEC患者在许多变量中的值低于非TOUEC患者。TOUEC组并发胆囊炎的发生率较低。考虑到手术时间，较短的持续时间也与较高的到达TOUEC的概率相关.
结论：了解影响TOUEC的因素可以使我们在教科书结果方面改善结果。
目的：本研究的目的是分析急性胆囊炎紧急早期胆囊切除术（UEC）患者的TO成就。并确定哪些因素与实现TO相关。
方法：这是SPRiMACC研究的事后研究。这是一项由WSES进行的前瞻性多中心观察性研究。在紧急早期胆囊切除术（TOUEC）中定义TO的标准是无30天死亡率，无术后30天并发症,30天内没有再入院，住院时间≤7天（第75百分位数），和全腹腔镜手术。满足所有这些条件的患者被视为呈现TOUEC。
结果：1246例紧急早期胆囊切除术治疗ACC。总之,789名患者（63.3%）达到所有TOUEC参数，而457（36.6％）未能达到一个或多个参数，被认为是非TOUEC。在所有分析的风险量表上，达到TOUEC的患者更年轻，得分明显较低。在血清学测试中，TOUEC患者在许多变量中的值低于非TOUEC患者。TOUEC组并发胆囊炎的发生率较低。考虑到手术时间，较短的持续时间也与较高的到达TOUEC的概率相关.
结论：了解影响TOUEC的因素可以使我们在教科书结果方面改善结果。
