Elderly patients (≥ 80 years) with acute calculous cholangitis have similar outcomes as non-elderly patients (< 80 years): Propensity score-matched analysis

Table 1 Patient demographics and clinical profile

	Overall cohort, n = 457				PSM cohort, n = 224
	Elderly, n = 318	Non-elderly, n = 139	P value	SMD	Elderly, n = 112	Non-elderly, n = 112	P value	SMD
Age, yr	84.0 (82.1, 86.6)	67.9 (57.1, 77.2)	< 0.001		84.3 (82.1, 87.3)	66.6 (55.6, 76.4)	< 0.001
Gender1, male (%)	132 (41.5)	73 (52.5)	0.029	0.221	57 (50.9)	53 (47.3)	0.593	0.071
Co-morbidities, n (%)
Diabetes mellitus	124 (39)	55 (39.6)	0.908		44 (39.3)	47 (42)	0.683
Ischemic heart disease1	87 (27.4)	27 (19.4)	0.071	0.188	22 (19.6)	23 (20.5)	0.868	0.022
Chronic renal impairment1	61 (19.2)	17 (12.2)	0.069	0.191	17 (15.2)	14 (12.5)	0.562	0.077
COPD and/or asthma	18 (5.7)	4 (2.9)	0.201		8 (7.1)	3 (2.7)	0.122
History of biliary disease1	182 (57.2)	58 (41.7)	0.002	0.313	50 (44.6)	53 (47.3)	0.688	0.054
Clinical presentation
Abdominal pain1	197 (61.9)	109 (78.4)	0.001	0.365	85 (75.9)	85 (75.9)	1.000	< 0.001
Fever1	141 (44.3)	67 (48.2)	0.446	0.077	50 (44.6)	52 (46.4)	0.788	0.036
Vomiting	142 (44.7)	63 (45.3)	0.895		51 (45.5)	50 (44.6)	0.893
Jaundice1	48 (15.1)	38 (27.3)	0.002	0.302	27 (24.1)	23 (20.5)	0.521	0.085
Hypotension1,2	18 (5.7)	12 (8.6)	0.238	0.115	10 (8.9)	6 (5.4)	0.299	0.138
Laboratory investigations
WBC1 (109/L)	12.4 (8.9, 16.1)	12.1 (8.3, 15.9)	0.551	0.113	12.2 (8.6, 15.4)	12.1 (8.0, 16.2)	0.745	0.100
Platelets1 (109/L)	192 (150, 250)	216 (166, 280)	0.047	0.131	193 (160, 252)	209 (162, 280)	0.308	0.101
Creatinine1 (μmol/L)	103 (81, 138)	89 (68, 116)	< 0.001	0.094	103 (80, 136)	86 (67, 119)	0.003	0.088
Albumin1 (g/L)	32 (28, 35)	35 (29, 38)	< 0.001	0.396	33 (29, 36)	34 (29, 38)	0.186	0.150
Bilirubin1 (μmol/L)	54 (33, 84)	60 (34, 96)	0.226	0.096	65 (42, 93)	58 (33, 93)	0.287	0.104
ALT (IU/L)	133 (61, 247)	143 (68, 295)	0.330		142 (82, 244)	123 (59, 263)	0.294
AST (IU/L)	160 (78, 366)	140 (72, 314)	0.165		176 (93, 365)	150 (74, 345)	0.149
ALP (IU/L)	209 (130, 346)	188 (117, 314)	0.149		208 (137, 346)	184 (111, 291)	0.136
GGT1 (IU/L)	242 (129, 435)	327 (158, 562)	0.006	0.292	286 (165, 504)	286 (133, 523)	0.591	0.022
INR1	1.13 (1.02, 1.30)	1.20 (1.10, 1.30)	0.890	0.112	1.15 (1.00, 1.30)	1.20 (1.10, 1.30)	0.506	0.038
Microbiology, positive (%)	132 (41.5)	48 (34.5)	0.160		44 (39.3)	36 (32.1)	0.265
Escherichia coli	99 (75)	30 (62.5)	0.100		33 (75)	24 (66.7)	0.413
Klebsiella pneumoniae	32 (24.2)	14 (29.2)	0.503		16 (36.4)	12 (33.3)	0.777
Enterobacter spp	3 (2.3)	1 (2.1)	0.939		0 (0)	1 (2.8)	0.266
Pseudomonas aeruginosa	1 (0.8)	0 (0)	0.550		0 (0)	0 (0)	-
Enterococcus spp	1 (0.8)	1 (2.1)	0.453		1 (2.3)	1 (2.8)	0.886
Citrobacter spp	1 (0.8)	0 (0)	0.545		1 (2.3)	0 (0)	0.357
Aeromonas spp	1 (0.8)	0 (0)	0.545		0 (0)	0 (0)	-
CT scan, n (%)	108 (34)	52 (37.4)	0.477		43 (38.4)	45 (40.2)	0.784
Cholelithiasis	75 (69.4)	31 (59.6)	0.218		21 (48.8)	14 (31.1)	0.089
Biliary dilation	47 (43.5)	18 (34.6)	0.283		30 (69.8)	26 (57.8)	0.243
Choledocholithiasis	63 (58.3)	18 (34.6)	0.005		27 (62.8)	14 (31.1)	0.003
MRCP, n (%)	157 (49.4)	73 (52.5)	0.536		61 (54.5)	55 (49.1)	0.422
Cholelithiasis	113 (72)	38 (52.1)	0.003		37 (60.7)	35 (63.6)	0.741
Biliary dilation	93 (59.2)	50 (68.5)	0.178		41 (67.2)	26 (47.3)	0.030
Choledocholithiasis	103 (65.6)	39 (53.4)	0.077		41 (67.2)	23 (41.8)	0.006
Shock Index, abnormal3	194 (61)	88 (63.3)	0.641		66 (58.9)	73 (65.2)	0.335
TG13 severity grading	2 (2, 3)	2 (1, 2)	< 0.001		2 (1, 3)	2 (1, 2)	0.016
Grade I	67 (21.1)	66 (47.5)			31 (27.7)	46 (41.1)
Grade II	152 (47.8)	46 (33.1)			49 (43.8)	46 (41.1)
Grade III	99 (31.1)	27 (19.4)			32 (28.6)	20 (17.9)

All continuous variables were expressed as median (interquartile range) unless specified. All categorical variables were expressed as n (%) unless otherwise specified.

¹Propensity score matching was performed for these variables due to potential and/or significant effects on clinical outcomes, or due to significant differences in demographics between the two study groups.

²Hypotension was defined as systolic blood pressure of < 90 mmHg.

³Shock index was defined as heart rate divided by the respective systolic blood pressure during triage, where the normal range is 0.5 to 0.7 (inclusive). ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; COPD: Chronic obstructive pulmonary disease; CT: Computed tomography; GGT: Gamma-glutamyl transferase; INR: International normalized ratio; MRCP: Magnetic resonance cholangiopancreatography; PSM: Propensity score matching; SMD: Standardized mean difference; TG13: Tokyo Guidelines 2013; WBC: White blood cell.