Early prediction of severe acute cholecystitis using routine admission parameters: a study of 1,330 patients
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By
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Alparslan Ertenlice
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Hikmet Pehlevan Özel
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Zeynep Nur Yurdakul
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Mehmet Sefa Çamöz
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Gözde İğdeci Tut
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Şule Bal
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İbrahim Kılınç
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Sadettin Er
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June 23, 2026
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Clinical Scorecard: Predicting Severe Acute Cholecystitis Early Through Standard Admission Metrics: Analysis of 1,330 Cases
At a Glance
| Category | Detail |
|---|
| Condition | Acute Cholecystitis |
| Key Mechanisms | Assessment of disease severity using clinical findings, laboratory parameters, and organ dysfunction criteria. |
| Target Population | Adults over the age of 18 diagnosed with acute cholecystitis. |
| Care Setting | Tertiary referral center |
Key Highlights
- Acute cholecystitis is a common surgical emergency with varying prevalence.
- Tokyo Guidelines 2018 (TG18) classify severity into mild, moderate, and severe.
- Severe cases are associated with increased complications and prolonged hospital stays.
- Predictive models using demographic and laboratory parameters are needed for early risk stratification.
- Objective biomarkers can aid in predicting disease severity and clinical outcomes.
Guideline-Based Recommendations
Diagnosis
- Utilize TG18 diagnostic and staging criteria for acute cholecystitis.
Management
- Cholecystectomy is the primary treatment; consider conservative management for high-risk patients.
Monitoring & Follow-up
- Monitor for complications such as perforation, abscess, and sepsis.
Risks
- Increased morbidity and mortality rates associated with severe acute cholecystitis.
Patient & Prescribing Data
Patients diagnosed with acute cholecystitis, excluding those with active infections or malignancies.
Alternative strategies include conservative management, percutaneous cholecystostomy, and elective cholecystectomy.
Clinical Best Practices
- Incorporate objective laboratory biomarkers for early assessment of disease severity.
- Evaluate clinical factors carefully in severe acute cholecystitis cases.
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