Risk Factors for Delayed Diagnosis of Acute Cholecystitis among Rural Older Patients: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting
2.2. Participants
2.3. Measurements
2.3.1. Primary Outcome
2.3.2. Independent Variables
2.4. Analyses
2.5. Ethical Considerations
3. Results
3.1. Participant Demographics
3.2. Relationship between the Time to Diagnosis and Demographic Factors
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Time to Diagnosis | |||
---|---|---|---|
Factor | ≤3 Days (Control) | >3 Days (Exposure) | p-Value |
N | 96 | 39 | |
Age, mean (SD) | 77.71 (14.62) | 80.13 (13.95) | 0.379 |
Age ≥ 80 years (%) | 51 (53.1) | 24 (61.5) | 0.446 |
Male sex (%) | 40 (41.7) | 25 (64.1) | 0.023 |
Albumin level, mean (SD) | 3.74 (0.67) | 3.29 (0.73) | 0.001 |
BMI, mean (SD) | 23.68 (4.13) | 21.70 (3.09) | 0.008 |
Creatinine level (SD) | 0.91 (0.48) | 0.90 (0.92) | 0.947 |
eGFR (SD) | 64.48 (20.87) | 64.16 (19.79) | 0.935 |
Hemoglobin level, mean (SD) | 12.96 (2.00) | 12.39 (1.60) | 0.119 |
White blood cell count (median) | 10.15 (3.00, 29.70) | 9.70 (3.60, 19.30) | 0.638 |
Total bilirubin level (median) | 1.30 (0.30, 7.00) | 1.20 (0.30, 7.20) | 0.602 |
Direct bilirubin level (median) | 0.50 (0.10, 5.30) | 0.60 (0.10, 4.40) | 0.196 |
AST level (median) | 34 (11, 2319) | 56 (15, 1199) | 0.187 |
ALT level (median) | 34 (7, 849) | 56 (8, 726) | 0.437 |
ALP level (median) | 284(53, 1719) | 328 (70, 3232) | 0.197 |
FIM score at discharge | |||
Total FIM score (median) | 120 (18, 126) | 80 (18, 126) | 0.03 |
Motor domain score (median) | 85 (11, 91) | 63 (13, 91) | 0.054 |
Cognitive domain score (median) | 35.00 (5, 35) | 32 (5, 35) | 0.019 |
Abdominal pain (%) | 70 (72.9) | 19 (48.7) | 0.009 |
Systolic blood pressure (SD) | 130.23 (25.51) | 126.92 (21.63) | 0.478 |
Diastolic blood pressure (SD) | 76.49 (14.70) | 75.46 (16.34) | 0.722 |
Heart rate (SD) | 86.28 (18.65) | 84.67 (17.85) | 0.645 |
Fever (%) | 32 (33.3) | 14 (35.9) | 0.842 |
Respiratory rate (SD) | 20.07 (4.52) | 20.44 (5.36) | 0.76 |
SpO2 (SD) | 96.09 (2.20) | 95.51 (2.53) | 0.194 |
CCI score ≥ 5 (%) | 53 (55.2) | 23 (59.0) | 0.707 |
CCI score (%) | |||
1 | 7 (7.3) | 2 (5.2) | |
2 | 9 (9.4) | 2 (5.1) | |
3 | 6 (6.2) | 4 (10.3) | |
4 | 21 (21.9) | 8 (20.5) | |
5 | 14 (14.6) | 8 (20.5) | |
6 | 16 (16.7) | 6 (15.4) | |
7 | 10 (10.4) | 4 (10.3) | |
8 | 6 (6.2) | 3 (7.7) | |
9 | 2 (2.1) | 2 (5.1) | |
10 | 4 (4.2) | 0 (0.0) | |
11 | 1 (1.0) | 0 (0.0) | |
Heart failure (%) | 13 (13.5) | 7 (17.9) | 0.594 |
MI (%) | 6 (6.2) | 1 (2.6) | 0.673 |
Asthma (%) | 5 (5.2) | 2 (5.1) | 1 |
Peptic ulcer (%) | 19 (19.8) | 8 (20.5) | 1 |
Kidney disease (%) | 13 (13.5) | 2 (5.1) | 0.23 |
Liver disease (%) | 5 (5.2) | 4 (10.3) | 0.281 |
COPD (%) | 3 (3.1) | 1 (2.6) | 1 |
DM (%) | 19 (19.8) | 7 (17.9) | 1 |
Brain infarction (%) | 22 (22.9) | 4 (10.3) | 0.147 |
Brain hemorrhage (%) | 0 (0.0) | 1 (2.6) | 0.289 |
Hemiplegia (%) | 8 (8.3) | 3 (7.7) | 1 |
Connective tissue disease (%) | 2 (2.1) | 1 (2.6) | 1 |
Dementia (%) | 21 (21.9) | 11 (28.2) | 0.504 |
Cancer (%) | 17 (17.7) | 3 (7.7) | 0.184 |
Living with family | 86 (89.6) | 30 (76.9) | 0.098 |
Dependent condition (%) | 27 (28.1) | 16 (41.0) | 0.158 |
Care level (%) | |||
0 | 69 (71.9) | 23 (59.0) | 0.336 |
1 | 5 (5.2) | 3 (7.7) | |
2 | 7 (7.3) | 6 (15.4) | |
3 | 7 (7.3) | 2 (5.1) | |
4 | 6 (6.2) | 2 (5.1) | |
5 | 2 (2.1) | 3 (7.7) |
Factor | Odds Ratio | 95% CI | p-Value |
---|---|---|---|
Abdominal pain | 0.57 | 0.24–1.39 | 0.22 |
Male sex | 0.43 | 0.18–1.01 | 0.05 |
Albumin | 0.51 | 0.28–0.94 | 0.032 |
BMI | 0.90 | 0.80–1.01 | 0.07 |
Total FIM score | 1.00 | 0.99–1.01 | 0.93 |
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Ikeda, H.; Ohta, R.; Sano, C. Risk Factors for Delayed Diagnosis of Acute Cholecystitis among Rural Older Patients: A Retrospective Cohort Study. Medicina 2022, 58, 1392. https://doi.org/10.3390/medicina58101392
Ikeda H, Ohta R, Sano C. Risk Factors for Delayed Diagnosis of Acute Cholecystitis among Rural Older Patients: A Retrospective Cohort Study. Medicina. 2022; 58(10):1392. https://doi.org/10.3390/medicina58101392
Chicago/Turabian StyleIkeda, Hirotaka, Ryuichi Ohta, and Chiaki Sano. 2022. "Risk Factors for Delayed Diagnosis of Acute Cholecystitis among Rural Older Patients: A Retrospective Cohort Study" Medicina 58, no. 10: 1392. https://doi.org/10.3390/medicina58101392