Symptomatic gallstone disease: Recurrence patterns and risk factors for relapse after first admission, the RELAPSTONE study.
United European Gastroenterol J
; 12(3): 286-298, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38376888
ABSTRACT
BACKGROUND:
Delayed cholecystectomy in patients with symptomatic gallstone disease is associated with recurrence. Limited data on the recurrence patterns and the factors that determine them are available.OBJECTIVE:
We aimed to determine the pattern of relapse in each symptomatic gallstone disease (acute pancreatitis, cholecystitis, cholangitis, symptomatic choledocholithiasis, and biliary colic) and determine the associated factors.METHODS:
RELAPSTONE was an international multicenter retrospective cohort study. Patients (n = 3016) from 18 tertiary centers who suffered a first episode of symptomatic gallstone disease from 2018 to 2020 and had not undergone cholecystectomy during admission were included. The main outcome was relapse-free survival. Kaplan-Meier curves were used in the bivariate analysis. Multivariable Cox regression models were used to identify prognostic factors associated with relapses.RESULTS:
Mean age was 76.6 [IQR 59.7-84.1], and 51% were male. The median follow-up was 5.3 months [IQR 2.1-12.4]. Relapse-free survival was 0.79 (95% CI 0.77-0.80) at 3 months, 0.71 (95% CI 0.69-0.73) at 6 months, and 0.63 (95% CI 0.61-0.65) at 12 months. In multivariable analysis, older age (HR = 0.57; 95% CI 0.49-0.66), sphincterotomy (HR = 0.58, 95% CI 0.49-0.68) and higher leukocyte count (HR = 0.79; 95% CI 0.70-0.90) were independently associated with lower risk of relapse, whereas higher levels of alanine aminotransferase (HR = 1.22; 95% CI 1.02-1.46) and multiple cholelithiasis (HR = 1.19, 95% CI 1.05-1.34) were associated with higher relapse rates.CONCLUSION:
The relapse rate is high and different in each symptomatic gallstone disease. Our independent predictors could be useful for prioritizing patients on the waiting list for cholecystectomies.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pancreatite
/
Coledocolitíase
Limite:
Aged
/
Female
/
Humans
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Male
Idioma:
En
Revista:
United European Gastroenterol J
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Espanha