[Bacteremia -- prevalence and associated factors in patients with acute calculous cholecystitis].
BACKGROUND
Bacteremia seems to increase the morbidity and mortality in clinical and surgical conditions, however the importance and factors associated with it during acute calculous cholecystitis are not well established. The purpose of this study was to determine pre-operative prevalence, associated factors and prognosis of bacteremia in patients with acute calculous cholecystitis submitted to an emergency cholecystectomy.


METHODS
A prospective study of 51 patients with histological diagnosis of acute calculous cholecystitis was designed. The Bactec System was used to detect bacteremia. Mean results of clinical and laboratory analyses were related to the presence of bacteremia.


RESULTS
The pre-operative prevalence of bacteremia was of 15.68%. Age (P=0.024), heart rate (P=0.026), respiratory rate (P=0.028), serum creatinine (P=0.028) and presence of systemic inflammatory response syndrome (P=0.016) were positively associated with bacteremia. Bacteremic patients had statistically higher overall (P=0.045) and infectious (P=0.039) complication rates and longer hospitalization (P<0.005) including one death.


CONCLUSIONS
Patients with acute calculous cholecystitis have a considerable prevalence of bacteremia in the pre-operative period. It is associated with old age, heart rate, respiratory rate, serum creatinine and systemic inflammatory response syndrome. In patients with acute calculous cholecystitis, presence of bacteremia may be associated to severity of the condition and poor outcome related to pos-operative complications.
Baitello
André Luciano
AL
Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP.
Colleoni Neto
Ramiro
R
Herani Filho
Benedito
B
Cordeiro
José Antônio
JA
Machado
Antônia M O
AM
Godoy
Moacir F
MF
Gaia
Felipe Franco Pinheiro
FF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001938:Brazil / Q000453:epidemiology; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000382:microbiology*; D004927:Escherichia coli Infections / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology; D008875:Middle Aged; D011300:Preoperative Care; D015995:Prevalence; D011446:Prospective Studies; D018709:Statistics, Nonparametric