Clinical characteristics and short-term outcomes in patients with acute cholecystitis over aged >80 years

Aim We investigated the clinical characteristics and short-term outcomes in acute cholecystitis (AC) patients aged >= 80 years. We therefore sought to determine the ideal treatment for elderly patients with AC. Methods We retrospectively evaluated 253 patients with AC. The patients were divided into two groups according to their age: elderly group (n = 77, aged >= 80 years) and non-elderly group (n = 176, aged <80 years). We compared the clinical characteristics, in-hospital mortality and recurrence of cholecystitis within 6 months between the two groups. The predictive factors for in-hospital mortality were also assessed. Results The elderly group had more severe comorbidities (P = 0.0055), higher severity grade of AC (P = 0.00071) and higher in-hospital mortality (P = 0.029) than the non-elderly group. The multivariate analysis showed that the serum creatinine level (hazard ratio 12.43; P = 0.002) was independently associated with the in-hospital mortality. The elderly group (20.8%) underwent subsequent cholecystectomy less frequently than the non-elderly group (63.2%; P < 0.0001). The recurrence rate of AC was comparable between the two groups (P = 0.89). The proportion of patients in the elderly group who received percutaneous drainage in the latter period (64.3%) was significantly higher than in the former period (33.3%; P = 0.015). Conclusions More attention should be paid to AC patients with chronic renal disease after treatment. Percutaneous drainage might serve as a definitive treatment without subsequent cholecystectomy in elderly AC patients with various comorbidities. Geriatr Gerontol Int 2019; 19: 208-212.