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- W4312876413 abstract "Introduction: Currently, selection for cholecystectomy in patients with uncomplicated cholecystolithiasis is based on the Rome-III criteria; severe pain attacks, in the right upper quadrant, and lasting 15-30 minutes or longer. This study evaluates these Rome-criteria and a new prediction model based on pre-operative variables for outcome after cholecystectomy. Methods: In two multicenter, prospective trials, the SECURE and SUCCESS, patients from 25 Dutch hospitals with symptomatic, uncomplicated cholecystolithiasis were included between April’14-June’19. We evaluated the Rome-criteria to predict a pain-free state or clinically relevant pain reduction after surgery. Furthermore, we developed and validated a multivariable model to predict both outcomes after surgery. Model performance was evaluated using calibration and discrimination. Results: We included 1,561 patients, of which 494 patients in the SUCCESS cohort. In the SUCCESS cohort, 80% underwent cholecystectomy. After, 57% was pain-free and 80% reported a clinically relevant pain reduction. A prediction model based on the Rome-criteria poorly predicted a pain-free state or clinically relevant pain reduction (c-statistic 0.56 (95%CI 0.50-0.61) and 0.59 (95%CI 0.50-0.67), respectively). A multivariable model showed that increased age, no history of abdominal surgery, increased baseline VAS pain-score, pain-radiation to the back, pain-reduction with simple analgesics, nausea, and no heartburn are independent predictors of clinically relevant post-operative pain reduction. After validation, good discrimination between patients with and without clinically relevant pain reduction was found (c-statistic 0.80 (95%CI 0.74-0.84). Conclusion: A comprehensive model with the SUCCESS-criteria better predicts outcome in patients after a cholecystectomy compared with a prediction model based on current Rome-III criteria." @default.
- W4312876413 created "2023-01-05" @default.
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- W4312876413 date "2022-01-01" @default.
- W4312876413 modified "2023-10-18" @default.
- W4312876413 title "Comparison of the ROME-III Criteria and a New Multivariable Prediction Model for the Selection of Patients with Symptomatic Cholecystolithiasis for Cholecystectomy" @default.
- W4312876413 doi "https://doi.org/10.1016/j.hpb.2022.05.1080" @default.
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