Yacoub et al developed a simple score for evaluating patients with acute cholecystitis. This can help to identify a patient who may benefit from emergency cholecystectomy. The authors are from the University of Southern California in Los Angeles.
Patient selection: acute cholecystitis
Parameters:
(1) age in years
(2) gender
(3) white blood cell (WBC) count per µL
(4) heart rate in beats per minute
(5) gallbladder wall thickness in mm
Parameter
Finding
Points
age in years
<= 45 years
0
> 45 years
1
gender
female
0
male
2
WBC count
<= 13,000 per µL
0
> 13,000 per µL
1.5
heart rate
<= 90 beats per minute
0
> 90 beats per minute
1
gallbladder wall
<= 4.5 mm
0
> 4.5 mm
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6.5
• The higher the score the greater the chances of gangrenous cholecystitis. However, gangrenous cholecystitis can occur in any risk group.
Score
Risk Gangrenous
0 to 2
low
2.5 to 4.5
intermediate
5 to 6.5
high
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