The Cholecystectomy As A Day Case (CAAD) score: a validated score of preoperative predictors of successful day-case cholecystectomy using the CholeS data set

El-Sharkawy, A.M. et al. (2019) The Cholecystectomy As A Day Case (CAAD) score: a validated score of preoperative predictors of successful day-case cholecystectomy using the CholeS data set. World Journal of Surgery, 43(8), pp. 1928-1934. (doi: 10.1007/s00268-019-04981-5) (PMID:31016355)

Abstract

Background: Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods: Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results: Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions: The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lammy, Dr Simon
• Authors: El-Sharkawy, A.M., Tewari, N., Vohra, R.S., Vohra, R.S., Pasquali, S., Kirkham, A.J., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E.A., Fenwick, S., Elmasry, M., Nunes, Q., Kennedy, D., Basit Khan, R., Khan, M.A., Magee, C.J., Jones, S.M., Mason, D., Parappally, C.P., Mathur, P., Saunders, M., Jamel, S., Ul Haque, S., Zafar, S., Shiwani, M.H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R.S., Watkin, H., Naumann, D., Emeshi, S., Sarmah, P.B., Lee, K., Joji, N., Heath, J., Teasdale, R.L., Weerasinghe, C., Needham, P.J., Welbourn, H., Forster, L., Finch, D., Blazeby, J.M., Robb, W., McNair, A.G., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.B., Jayanthi, N.V., Noor, N., Dobbins, B., Cockbain, A.J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J.B., Ho, W.M., Miu, V., White, T.J., Hodgkins, K.A., Kinghorn, A., Tutton, M.G., Al-Abed, Y.A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L.J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S.J., McCallum, I.J., Jones, M.J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K.B., Kimble, A., Bunting, D.M., Fawole, A.S., Basheer, M., Dave, R.V., Sarveswaran, J., Jones, E., Kendall, C.J., Tilston, M.P., Gough, M., Wallace, T., Singh, S., Downing, J., Mockford, K.A., Issa, E., Shah, N., Chauhan, N., Wilson, T.R., Forouzanfar, A., Wild, J.R., Nofal, E., Bunnell, C., Madbak, K., Rao, S.T., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J.C., Gould, L., Chambers, A., Urriza Rodriguez, D., Sen, G., Robinson, S., Carney, K., Bartlett, F., Rae, D.M., Stevenson, T.E., Sarvananthan, K., Dwerryhouse, S.J., Higgs, S.M., Old, O.J., Hardy, T.J., Shah, R., Hornby, S.T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E.A., Frame, R.J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T.O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W.S., Fleming, K., Singh Bajwa, D., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M.A., Bellini, M.I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa Nusrat Iqbal, L., Watson, N.F., Kumar Aggarwal, S., Orchard, P., Villatoro, E., Willson, P.D., Wa, K., Mok, J., Woodman, T., Deguara, J., Garcea, G., Babu, B.I., Dennison, A.R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J.P., Jones, R.P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M.M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S.R., Sampat, K., M O?shea, K., Manu, M., Asprou, F.M., Malik, N.S., Chang, J., Johnstone, M., Lewis, M., Roberts, G.P., Karavadra, B., Photi, E., Hewes, J., Gould, L., Chambers, A., Rodriguez, D., O?Reilly, D.A., Rate, A.J., Sekhar, H., Henderson, L.T., Starmer, B.Z., Coe, P.O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A.E., Borowski, D.W., Hornsby, J., Courtney, M.J., Virupaksha, S., Seymour, K., Robinson, S., Hawkins, H., Bawa, S., Gallagher, P.V., Reid, A., Wood, P., Finch, J.G., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F.M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D.R., Al-Khyatt, W., Bhandari, C.T., Chambers, A., Subramanium, D., Toh, S.K., Carter, N.C., Mercer, S.J., Knight, B., Tate, S., Pearce, B., Wainwright, D., Vijay, V., Alagaratnam, S., Sinha, S., Khan, S., El-Hasani, S.S., Hussain, A.A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M.N., Chishti, I.A., Fordham, I.J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Kiran Shrestha, A., Basu, S., Chhabra Mohan Harilingam, A., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S.F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M.I., Ball, W.R., Wood, C.P., Pinho-Gomes, A.C., Kausar, A., Rami Obeidallah, M., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S.Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M.R., Li Goh, Y., Turner, P., Shetty, V., Riera, M., Macano, C.A., Sukha, A., Preston, S.R., Hoban, J.R., Puntis, D.J., Williams, S.V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G.H., Smith, S.R., Hall, C., Carty, N., Ahmed, J., Panteleimonitis, S., Gunasekera, R.T., Sheel, A.R., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E.R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D.A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C.R., Yeldham, G., Read, E., Gossage, J.A., Rolph, R.C., Ebied, H., Phull, M., Khan, M.A., Popplewell, M., Kyriakidis, D., Hussain, A., Henley, N., Packer, J.R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N.A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A.R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J.P., Pearson, K.L., Delisle, T.G., Davies, J., Tomlinson, M.A., Johnpulle, M.A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Sidhartha Mothe, B., Zafrani, Z., Brett, D., Francombe, J., Spreadborough, P., Barnes, J., Cheung, M., Al-Bahrani, A.Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P.A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R.C., Hebbar, M., Farag, S.F., Spearman, J., Hamdan, M.F., D?Costa, C., Blane, C., Giles, M., Peter, M.B., Hirst, N.A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T.E., Taylor, G.W., Thompson, R.L., McCune, K., Loughlin, P., Lawther, R., Byrnes, C.K., Simpson, D.J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W.M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A.D., Cassidy, J.T., Boland, M., Burke, P., Nally, D.M., Hill, A.D., Khogali, E., Shabo, W., Iskandar, E., McEntee, G.P., O?Neill, M.A., Peirce, C., Lyons, E.M., O?Sullivan, A.W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D.C., Kelly, M.E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J.G., Martin, S.T., McDermott, F., Cross, K.S., Cooke, F., Zeeshan, S., Murphy, J.O., Mealy, K., Mohan, H.M., Nedujchelyn, K., Fahad Ullah, M., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A.M., Vaughan, E.M., Ramage, M.I., Aldridge, R.C., Gibson, S., Nicholson, G.A., Vass, D.G., Grant, A.J., Holroyd, D.J., Jones, M.A., Sutton, C.M., O?Dwyer, P., Nilsson, F., Weber, B., Williamson, T.K., Lalla, K., Bryant, A., Carter, C.R., Forrest, C.R., Hunter, D.I., Nassar, A.H., Orizu, M.N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A.T., Guthrie, G.J., Lim, P.J., Luhmann, A., Watson, A.J., Richards, C.H., Nicol, L., Madurska, M., Harrison, E., Boyce, K.M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M.S., Dalgaty, F., Fothergill, L., Driscoll, P.J., Mozolowski, K.L., Banwell, V., Bennett, S.P., Rogers, P.N., Skelly, B.L., Rutherford, C.L., Mirza, A.K., Lazim, T., Lim, H.C., Duke, D., Ahmed, T., Beasley, W.D., Wilkinson, M.D., Maharaj, G., Malcolm, C., Brown, T.H., Shingler, G.M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D.J., Baker, A.L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J.A., Singh-Ranger, D., Hisham, E., Ainley, P., O?Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, S., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Weber, B., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., McGuigan, A., Shahin, Y., Ali, A., Luther, A., Nicholson, J.A., Rajendran, I., Boal, M., and Ritchie, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: World Journal of Surgery
• Publisher: Springer
• ISSN: 0364-2313
• ISSN (Online): 1432-2323
• Published Online: 23 April 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in World Journal of Surgery 43(8): 1928-1934
• Publisher Policy: Reproduced under a Creative Commons License

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