Woohyung Lee1, Jae Yool Jang2, Jin-Kyu Cho2, Soon-Chan Hong2, Chi-Young Jeong3. 1. Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Republic of Korea; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 2. Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Republic of Korea. 3. Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Republic of Korea. Electronic address: drjcy@hanmail.net.
Abstract
BACKGROUND: The Parkland grading scale (PGS) was assessed to validate its correlation to severity of acute cholecystitis (AC). METHODS: This study investigated the correlation between the PGS and Tokyo guidelines (TG) using multinomial logistic regression analysis in 177 patients with AC. RESULTS: High PGS grades were related to higher C-reactive protein (p < 0.001) and frequent gangrenous cholecystitis (p < 0.001). The PGS and TG grades correlated with statistical significance (p < 0.001). Patients with PGS Grade 4 had a higher risk of moderate AC than those with Grade 3 (odds ratio: 4.4; 95% confidence interval [CI]: 1.2-15.6; p = 0.019). The PGS showed good predictive power for moderate or severe AC (area under the curve: 0.771; 95% CI: 0.700-0.842; p = 0.031). CONCLUSION: The PGS is helpful to discriminate severity of AC. Patients with PGS Grade 4 or 5 have a high risk of moderate or severe AC.
BACKGROUND: The Parkland grading scale (PGS) was assessed to validate its correlation to severity of acute cholecystitis (AC). METHODS: This study investigated the correlation between the PGS and Tokyo guidelines (TG) using multinomial logistic regression analysis in 177 patients with AC. RESULTS: High PGS grades were related to higher C-reactive protein (p < 0.001) and frequent gangrenous cholecystitis (p < 0.001). The PGS and TG grades correlated with statistical significance (p < 0.001). Patients with PGS Grade 4 had a higher risk of moderate AC than those with Grade 3 (odds ratio: 4.4; 95% confidence interval [CI]: 1.2-15.6; p = 0.019). The PGS showed good predictive power for moderate or severe AC (area under the curve: 0.771; 95% CI: 0.700-0.842; p = 0.031). CONCLUSION: The PGS is helpful to discriminate severity of AC. Patients with PGS Grade 4 or 5 have a high risk of moderate or severe AC.