title: 'Lewisham scoring system' to facilitate the clinical diagnosis of empyema.
abstract: BACKGROUND
  Patients with empyema of gall bladder have a higher mortality rate. We hypothesised a scoring system, which we call the Lewisham Score, to predict the development and diagnosis of empyema.
  
  
  METHODS
  Patient with histologically proven acute cholecystitis who underwent operation over a five year period (2004-2009) were selected and a retrospective cohort analysis of those who developed empyema vs. simple acute cholecystitis was performed. Various parameters and the Lewisham score were compared.
  
  
  RESULTS
  Patients with empyema were elderly females with a higher C-reactive protein and had a higher Lewisham Score of > 5 and those with simple cholecystitis had a lower Lewisham score (< 4) and lower C-reactive protein.
  
  
  CONCLUSIONS
  Patients with proven acute cholecystitis and a Lewisham score > 5 should undergo cholecystectomy at the same admission.
authors.affiliation: Department of Surgery, University Hospital Lewisham, London SE13 6LH, UK. dr_durai@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Durai
authors.forename: X
authors.initials: X
authors.lastname: Cheng
authors.forename: C
authors.initials: C
authors.lastname: Fernandes
authors.forename: A
authors.initials: A
authors.lastname: Razvi
authors.forename: Ph C H
authors.initials: PC
authors.lastname: Ng
mesh_terms: D000368:Aged; D002097:C-Reactive Protein; D002763:Cholecystectomy; D002764:Cholecystitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D041881:Cholecystitis, Acute / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein