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Multicentre cohort study of acute cholecystitis management during the COVID-19 pandemic

2021; Springer Science+Business Media; Volume: 47; Issue: 3 Linguagem: Inglês

10.1007/s00068-021-01631-1

1863-9941

Javier Martínez Caballero, Lucía González, E. Rodríguez Cuéllar, Eduardo Ferrero Herrero, Cristina Pérez Algar, Víctor Vaello Jodrá, María Dolores Pérez Díaz, Jana Dziaková, Rosario San Román Romanillos, Marcello Di Martino, Ángela de la Hoz Rodríguez, Mónica Galán Martín, José Daniel Sánchez López, Mariana García Virosta, Marta de la Fuente Bartolomé, María de Mar Pardo de Lama, María Gutiérrez Samaniego, D Díaz Pérez, David Jiménez, Luis de Nicolás Navas, Juan José Pérez Alegre, Javier García-Quijada García, J Guevara-Martínez, Arantxa Villadoniga, Roberto Martínez Fernández,

Gallbladder and Bile Duct Disorders

To analyse acute cholecystitis (AC) management during the first pandemic outbreak after the recommendations given by the surgical societies estimating: morbidity, length of hospital stay, mortality and hospital-acquired SARS-CoV-2 infection rate. Multicentre-combined (retrospective–prospective) cohort study with AC patients in the Community of Madrid between 1st March and 30th May 2020. 257 AC patients were involved in 16 public hospital. Multivariant binomial logistic regression (MBLR) was applied to mortality. Of COVID-19 patients, 30 were diagnosed at admission and 12 patients were diagnosed during de admission or 30 days after discharge. In non-COVID-19 patients, antibiotic therapy was received in 61.3% of grade I AC and 40.6% of grade II AC. 52.4% of grade III AC were treated with percutaneous drainage (PD). Median hospital stay was 5 [3–8] days, which was higher in the non-surgical treatment group with 7.51 days (p < 0.001) and a 3.25% of mortality rate (p < 0.21). 93.3% of patients with SARS-CoV-2 infection at admission were treated with non-surgical treatment (p = 0.03), median hospital stay was 11.0 [7.5–27.5] days (p < 0.001) with a 7.5% of mortality rate (p > 0.05). In patients with hospital-acquired SARS-CoV-2 infection, 91.7% of grade I–II AC were treated with non-surgical treatment (p = 0.037), with a median hospital stay of 16 [4–21] days and a 18.2% mortality rate (p > 0.05). Hospital-acquired infection risk when hospital stay is > 7 days is OR 4.7, CI 95% (1.3–16.6), p = 0.009. COVID-19 mortality rate was 11.9%, AC severity adjusted OR 5.64 (CI 95% 1.417–22.64). In MBLR analysis, age (OR 1.15, CI 95% 1.02–1.31), SARS-CoV-2 infection (OR 14.49, CI 95% 1.33–157.81), conservative treatment failure (OR 8.2, CI 95% 1.34–50.49) and AC severity were associated with an increased odd of mortality. In our population, during COVID-19 pandemic, there was an increase of non-surgical treatment which was accompanied by an increase of conservative treatment failure, morbidity and hospital stay length which may have led to an increased risk hospital-acquired SARS-CoV-2 infection. Age, SARS-CoV-2 infection, AC severity and conservative treatment failure were mortality risk factors.