Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones. / Borly, L; Anderson, I B; Bardram, L; Christensen, E; Sehested, A; Kehlet, H; Matzen, P; Rehfeld, J F; Stage, P; Toftdahl, D B; Gernow, A; Højgaard, L.
In: Scandinavian Journal of Gastroenterology, Vol. 34, No. 11, 11.1999, p. 1144-52.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones
AU - Borly, L
AU - Anderson, I B
AU - Bardram, L
AU - Christensen, E
AU - Sehested, A
AU - Kehlet, H
AU - Matzen, P
AU - Rehfeld, J F
AU - Stage, P
AU - Toftdahl, D B
AU - Gernow, A
AU - Højgaard, L
PY - 1999/11
Y1 - 1999/11
N2 - BACKGROUND: After cholecystectomy for symptomatic gallstone disease 20%-30% of the patients continue to have abdominal pain. The aim of this study was to investigate whether preoperative variables could predict the symptomatic outcome after cholecystectomy.METHODS: One hundred and two patients were referred to elective cholecystectomy in a prospective study. Median age was 45 years; range, 20-81 years. A preoperative questionnaire on pain, symptoms, and history was completed, and the questions on pain and symptoms were repeated 1 year postoperatively. Preoperative cholescintigraphy and sonography evaluated gallbladder motility, gallstones, and gallbladder volume. Preoperative variables in patients with or without postcholecystectomy pain were compared statistically, and significant variables were combined in a logistic regression model to predict the postoperative outcome.RESULTS: Eighty patients completed all questionnaires. Twenty-one patients continued to have abdominal pain after the operation. Patients with pain 1 year after cholecystectomy were characterized by the preoperative presence of a high dyspepsia score, 'irritating' abdominal pain, and an introverted personality and by the absence of 'agonizing' pain and of symptoms coinciding with pain (P < 0.000001). In a constructed logistic regression model 15 of 18 predicted patients had postoperative pain (PVpos = 0.83). Of 62 patients predicted as having no pain postoperatively, 56 were pain-free (PVneg = 0.90). Overall accuracy was 89%.CONCLUSION: From this prospective study a model based on preoperative symptoms was developed to predict postcholecystectomy pain. Since intrastudy reclassification may give too optimistic results, the model should be validated in future studies.
AB - BACKGROUND: After cholecystectomy for symptomatic gallstone disease 20%-30% of the patients continue to have abdominal pain. The aim of this study was to investigate whether preoperative variables could predict the symptomatic outcome after cholecystectomy.METHODS: One hundred and two patients were referred to elective cholecystectomy in a prospective study. Median age was 45 years; range, 20-81 years. A preoperative questionnaire on pain, symptoms, and history was completed, and the questions on pain and symptoms were repeated 1 year postoperatively. Preoperative cholescintigraphy and sonography evaluated gallbladder motility, gallstones, and gallbladder volume. Preoperative variables in patients with or without postcholecystectomy pain were compared statistically, and significant variables were combined in a logistic regression model to predict the postoperative outcome.RESULTS: Eighty patients completed all questionnaires. Twenty-one patients continued to have abdominal pain after the operation. Patients with pain 1 year after cholecystectomy were characterized by the preoperative presence of a high dyspepsia score, 'irritating' abdominal pain, and an introverted personality and by the absence of 'agonizing' pain and of symptoms coinciding with pain (P < 0.000001). In a constructed logistic regression model 15 of 18 predicted patients had postoperative pain (PVpos = 0.83). Of 62 patients predicted as having no pain postoperatively, 56 were pain-free (PVneg = 0.90). Overall accuracy was 89%.CONCLUSION: From this prospective study a model based on preoperative symptoms was developed to predict postcholecystectomy pain. Since intrastudy reclassification may give too optimistic results, the model should be validated in future studies.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Chi-Square Distribution
KW - Cholecystectomy
KW - Cholelithiasis
KW - Female
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Pain Measurement
KW - Postoperative Complications
KW - Predictive Value of Tests
KW - Preoperative Care
KW - Prospective Studies
KW - Statistics, Nonparametric
KW - Surveys and Questionnaires
KW - Treatment Outcome
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
M3 - Journal article
C2 - 10582767
VL - 34
SP - 1144
EP - 1152
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 11
ER -
ID: 165891396