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Article

Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database

by
Paola Fugazzola
1,2,
Ahmed Ghaly
1,2,*,
Luca Ansaloni
1,2,
Francesca Dal Mas
3,4,
Carlo Maria Bianchi
1,2,
Enrico Cicuttin
1,
Andrea Dagnoni
1,2,
Simone Frassini
1,2,
Matteo Tomasoni
1,
Lorenzo Cobianchi
1,2,4 and
the SPRiMACC Collaborative Group
†
1
General Surgery Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
2
Department of Clinical, Surgical, Diagnostic & Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
3
Venice School of Management, Ca’ Foscari University of Venice, 30123 Venice, Italy
4
Collegium Medicum, University of Social Sciences, 90-237 Lodz, Poland
*
Author to whom correspondence should be addressed.
†
Collaborators/Membership of the Group/Team Name is provided in the Acknowledgments.
Medicina 2025, 61(7), 1228; https://doi.org/10.3390/medicina61071228
Submission received: 25 May 2025 / Revised: 16 June 2025 / Accepted: 2 July 2025 / Published: 7 July 2025
(This article belongs to the Section Surgery)
Review Reports Versions Notes

Abstract

Background and Objectives: Early cholecystectomy (EC) is widely regarded as the first-line treatment for acute calculous cholecystitis (ACC). Current debate centers on the feasibility of EC as an option even for elderly patients. This study aims to determine whether age alone is an independent risk prediction factor for prognosis after EC for ACC. Materials and Methods: This study is a post-hoc analysis of the S.P.Ri.M.A.C.C. WSES prospective international multicenter observational study database, including patients with ACC undergoing EC. Univariate and multivariate analyses were conducted, examining different risk factors for major morbidity and mortality after EC. Results: In the univariate analyses, age was found to be a statistically significant risk factor for both 30-day major complications (p < 0.001) and 30-day mortality (p = 0.003). However, in the multivariate analysis, age alone was not a significant predictor for either outcome, with p-values of 0.419 and 0.094, respectively. The only significant risk factor associated with both 30-day mortality and major morbidity in the multivariate model was the POSSUM Physiological Score (PS). Conclusions: Age alone cannot be considered a reliable risk predictor for a complicated postoperative course after EC in patients with ACC. Frailty, rather than chronological age, should be assessed to predict the outcome of these patients.
Keywords: early cholecystectomy (EC); acute calculous cholecystitis (ACC); world society of emergency surgery (WSES); Tokyo guidelines 18 (TG18) early cholecystectomy (EC); acute calculous cholecystitis (ACC); world society of emergency surgery (WSES); Tokyo guidelines 18 (TG18)

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MDPI and ACS Style

Fugazzola, P.; Ghaly, A.; Ansaloni, L.; Dal Mas, F.; Bianchi, C.M.; Cicuttin, E.; Dagnoni, A.; Frassini, S.; Tomasoni, M.; Cobianchi, L.; et al. Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database. Medicina 2025, 61, 1228. https://doi.org/10.3390/medicina61071228

AMA Style

Fugazzola P, Ghaly A, Ansaloni L, Dal Mas F, Bianchi CM, Cicuttin E, Dagnoni A, Frassini S, Tomasoni M, Cobianchi L, et al. Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database. Medicina. 2025; 61(7):1228. https://doi.org/10.3390/medicina61071228

Chicago/Turabian Style

Fugazzola, Paola, Ahmed Ghaly, Luca Ansaloni, Francesca Dal Mas, Carlo Maria Bianchi, Enrico Cicuttin, Andrea Dagnoni, Simone Frassini, Matteo Tomasoni, Lorenzo Cobianchi, and et al. 2025. "Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database" Medicina 61, no. 7: 1228. https://doi.org/10.3390/medicina61071228

APA Style

Fugazzola, P., Ghaly, A., Ansaloni, L., Dal Mas, F., Bianchi, C. M., Cicuttin, E., Dagnoni, A., Frassini, S., Tomasoni, M., Cobianchi, L., & the SPRiMACC Collaborative Group. (2025). Age Is Not So Important for Risk Stratification in Early Cholecystectomy for Acute Calculous Cholecystitis: A Post-Hoc Analysis of the SPRiMACC Study Database. Medicina, 61(7), 1228. https://doi.org/10.3390/medicina61071228

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