Surgical approach is still controversial in patients with acute cholecystitis: to treat clinically the inflammatory process and operate electively later or to operate immediately on an emergency basis?
To test the hypothesis that urgent laparoscopic cholecystectomy in acute cholecystitis has a higher mortality than elective laparoscopic cholecystectomy.
From the data available in Datasus, mortality was compared between patients undergoing elective laparoscopic cholecystectomy for cholelithiasis and in urgency. Calculations were made of the relative reduction in risk of death, absolute reduction of risk of death and number needed to treat.
From 2009 to 2014 in Brazil, there were 250.439 laparoscopic cholecystectomy and 74.6% were electives. Mortality in the emergency group was 4.8 times higher compared to the elective group (0.0023% vs. 0.00048%). Despite the relative reduction in risk of death (RRR) was 83%, in the calculation of absolute risk was found 0.0018 and number needed to treat of 55,555.
Despite the relative risk reduction for mortality was high comparing elective vs. urgent basis, the absolute risk reduction was minimal, since this outcome is very low in both groups, suggesting that mortality should not have much influence on surgical decision.
Continua controversa a conduta nos pacientes com colecistite aguda: compensar o processo inflamatório e operar eletivamente ou operar imediatamente em caráter de urgência?
Testar a hipótese de que a colecistectomia videolaparoscópica de urgência por colecistite aguda apresenta maior mortalidade que a colecistectomia videolaparoscópica eletiva.
A partir dos dados disponíveis no Datasus, foi comparada a mortalidade entre os pacientes submetidos à colecistectomia videolaparoscópica eletiva por colelitíase e a de urgência. Foram realizados cálculos da redução relativa de risco de morte, redução absoluta do risco de morte e número necessário para tratar .
De 2009 a 2014 no Brasil, foram realizadas 250.439 colecistectomias videolaparoscópicas sendo 74,6% eletivas. A mortalidade no grupo de emergência foi 4,8 vezes mais elevada em comparação com o grupo eletivo (0,0023% vs. 0,00048%). Apesar da redução relativa do risco de morte (RRR) ser de 83%, no cálculo do risco absoluto encontrou-se 0,0018 e número necessário para tratar de 55.555.
Apesar da redução relativa de risco para mortalidade ser alta comparando o caráter eletivo vs. urgência, a redução de risco absoluto é mínima, já que esse desfecho é muito baixo nos dois grupos, sugerindo que a mortalidade não deve ter muita influência na tomada de decisão cirúrgica.
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 May 2018.
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#23,324,148
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Outputs from ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
#170
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#316,261
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Outputs of similar age from ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
#11
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So far Altmetric has tracked 315 research outputs from this source. They receive a mean Attention Score of 3.7. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
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