Abnormal blood glucose on admission and outcomes in older patients with acute calculous cholecystitis.

introductionWe investigated the potential correlation between abnormal blood glucose on admission and clinical outcomes of acute calculus cholecystitis in older patients. AREAS COVERED: We included older patients (≥65 years) diagnosed with acute calculus cholecystitis. The first plasma glucose measurement obtained at admission was used. Overall, 280 older patients were evaluated. The results showed that ABG was significantly associated with more severe systemic inflammatory responses (elevated white blood cell count and neutrophil-lymphocyte ratio), a higher incidence of moderate to severe ACC, and the need for invasive treatment (an increased proportion of percutaneous cholecystostomy and combined surgeries). The prolonged hospital stay, 30-day readmission rate and mortality rate of patients in the ABG group were significantly increased, and the incidence of severe postoperative complications (Clavien-Dindo≥grade III) was higher. Multivariate analysis confirmed that ABG was an independent predictor of the severity of ACC (TG18 classification) and 30-day re-admission rate. EXPERT OPINION/COMMENTARY: In older patients with acute calculus cholecystitis, abnormal blood glucose on admission is associated with worse outcomes, serving as a novel quantifiable risk criterion to guide treatment selection, particularly for high-risk older adults ineligible for early surgery.