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Inflammation-based prognostic scores predict disease severity in patients with acute cholecyｓtitis

萩原, 雅子 東京慈恵会医科大学 DOI:info:doi/10.1097/MEG.0000000000001063

2020.12.25

概要

Background: Although several investigators have reported that inflammation-based prognostic scores are able to predict disease severity in patients with various inflammatory diseases, whether or not these scores are associated with disease severity in patients with acute cholecystitis (AC) has not yet been fully clarified.

Materials and Methods: Two-hundred and sixty-two patients with acute cholecystitis were retrospectively reviewed. We evaluated the correlations between demographic or clinical variables, including the neutrophil-to-lymphocyte ratio (NLR), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), and CRP/albumin (CRP/Alb) ratio, as well as the disease severity grade based on the revised Tokyo guidelines (TG 13). Multivariate analyses were performed to identify the clinical parameters associated with disease severity grade.

Results: The NLR (P<0.0001), GPS (P<0.0001), mGPS (P<0.0001), and CRP/Alb ratio (P<0.0001), were all elevated according to the severity grade. Multivariate analyses revealed that the NLR (odds ratio (OR) 3.41-4.77; P<0.005), GPS (OR 2.49; P=0.012), mGPS (OR 2.79; P=0.005), and CRP/Alb ratio (OR 12.53; P<0.0001) were independently associated with Grade II / Grade III AC. The value of the area under the curve of the CRP/Alb ratio (continuous 0.759) or NLR (continuous 0.753) was higher than that of other inflammation-based prognostic scores for diagnosing ≥ Grade II AC, Grade III AC, respectively

Conclusion: Inflammation-based prognostic scores were able to predict the severity grade independently in patients with AC. These scores may have a complementary role in predicting disease severity in patients with AC in conjunction with the TG 13 severity grade.

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