Predictive value of biochemical markers and clinical scoring systems for outcomes in nonagenarians and centenarians admitted to the ICU after cholecystectomy for acute cholecystitis: a binational multicenter analysis
Retrospective analysis identifies clinical predictors of mortality in nonagenarians after cholecystectomy, highlighting the need for improved risk stratification.
Key Points
This study aims to identify predictors of mortality and resource use in ICU patients aged 90 and older after cholecystectomy for acute cholecystitis.
Retrospective cohort study using data from the Australian and New Zealand Intensive Care Society Adult Patient Database (2010–2024)
Assessment of predefined clinical and biochemical predictors for 378 patients aged ≥ 90 years admitted to ICU after cholecystectomy
Outcomes analyzed included 1-year mortality, ICU length of stay, and 30-day mortality utilizing logistic regression and AUROC analyses.
1-year mortality in ICU patients was 17.7%, with significant mortality rates at other time points (ICU: 1.9%, 30-day: 7.9%)
Higher APACHE III and serum urea were independently associated with 1-year mortality, with urea providing the best discrimination among biochemical markers (AUROC 0.71)
High-risk groups identified by APACHE III and urea thresholds displayed substantially higher 1-year mortality compared to low-risk groups.