American journal of surgery · 2025
Multidimensional impacts of the Lebanese economic crisis on the management of acute cholecystitis.
СтатьяНазвание и аннотация: Перевод в очереди
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Chakhtoura Ghassan, Dargham Charbel, Abi Habib Farid, Saade Richard, El Hadi Christopher, Mouawad Christian, Osseis Michael, Gharios Joseph, Noun Roger
Аннотация
BACKGROUND: Lebanon's overlapping economic collapse, COVID-19 pandemic, and Beirut port explosion have profoundly strained healthcare delivery. We assessed their impact on the severity and surgical management of acute cholecystitis.
METHODS: We conducted a retrospective cohort study of 554 patients who underwent cholecystectomy between 2018 and 2024, comparing a pre-crisis period (2018-January 2020) with a crisis period (February 2020-2024). Monthly interrupted time series analyses and multivariable logistic regression models adjusting for age, ASA class, and inflammatory markers were performed.
RESULTS: Crisis-period patients presented later (median 2 vs 1 day) with higher WBC counts. The proportion of Tokyo Grade II-III cholecystitis increased from 22.5 % to 44.9 %, and the crisis period independently predicted higher severity (adjusted OR 3.27; 95 % CI 2.10-5.10). Postoperative complication and readmission rates remained stable.
CONCLUSION: Lebanon's crises were associated with delayed presentation and more severe acute cholecystitis, without worsening adjusted postoperative outcomes.
METHODS: We conducted a retrospective cohort study of 554 patients who underwent cholecystectomy between 2018 and 2024, comparing a pre-crisis period (2018-January 2020) with a crisis period (February 2020-2024). Monthly interrupted time series analyses and multivariable logistic regression models adjusting for age, ASA class, and inflammatory markers were performed.
RESULTS: Crisis-period patients presented later (median 2 vs 1 day) with higher WBC counts. The proportion of Tokyo Grade II-III cholecystitis increased from 22.5 % to 44.9 %, and the crisis period independently predicted higher severity (adjusted OR 3.27; 95 % CI 2.10-5.10). Postoperative complication and readmission rates remained stable.
CONCLUSION: Lebanon's crises were associated with delayed presentation and more severe acute cholecystitis, without worsening adjusted postoperative outcomes.