Correlation of Inpatients Suffering from Acute Acalculous Cholecystitis during ICU Treatment with Acute Physiology and Chronic Health Evaluation II Score, Duration of Ventilator Use, and Time on Total Parenteral Nutrition

Abstract

Objective. To explore the correlation of inpatients suffering from acute acalculous cholecystitis (AAC) during ICU treatment with Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, duration of ventilator use, and time on total parenteral nutrition (TPN). Methods. From March 2016 to March 2022, the clinical data of 47 patients with AAC who received ICU treatment in our hospital were retrospectively reviewed, and these patients were included in the AAC group. Another 36 patients treated in the ICU in the same period with age and gender matching with those in the AAC group were selected as the non-AAC group. Patients’ various clinical data were recorded to analyze the correlation of AAC with APACHE-II score, duration of ventilator use, and time on TPN. Results. The shock time, duration of ventilator usage, and duration of sedative medicine use were all substantially longer in the AAC group than in the non-AAC group, according to the univariate analysis ( P < 0.05 ); the amount of norepinephrine used, white blood cell count, C-reactive protein (CRP) amount, and APACHE-II score were significantly higher in the AAC group than in the non-AAC group ( P < 0.05 ); between the two groups, the time on TPN and fasting time were different, but with no statistical significance ( P > 0.05 ); after performing Spearman’s correlation with the significantly between-group different indicators, the result showed that the amount of norepinephrine used, duration of ventilator use, white blood cell count, and CRP amount were significantly correlated with the occurrence of AAC, and the correlation was positive ( P all <0.001). Conclusion. The APACHE-II score and time on TPN are not significantly correlated with the occurrence of AAC; and the amount of norepinephrine used, duration of ventilator use, white blood cell count, and serum CRP are positively correlated with the occurrence of AAC. Measuring the variations in the levels of various markers can signal the onset of AAC or reflect the state and prognosis, suggesting a possible application in clinic-based targeted prevention and treatment of AAC.

Colecistite alitiásica aguda em pacientes na terapia intensiva: uma revisão integrativa

“…O motivo mais comum de internação na UTI foi pneumonia, sepse e traumas, tendo um intervalo mediano de 11 dias para o diagnóstico de CAA após a admissão na UTI e um tempo médio de internação na terapia intensiva de 26,5 dias 8 . Foi observado que a influência da duração do uso da nutrição parenteral total, analgésicos, ventilação mecânica, drogas vasoativas e a duração do estado de choque colaborou não apenas no desenvolvimento da CAA, mas foi relatado que o uso desses fatores foram substancialmente maiores no grupo com CAA do que com colecistite calculosa aguda (CCA) 9 , 10 . Observa-se ainda que a incidência de bacteremia foi significativamente maior em pacientes com CAA, os quais frequentemente eram pacientes mais jovens e tinham um tempo de permanência maior na UTI 10 .…”