Baseline laboratory parameters as predictors of admission to intensive care unit after laparoscopic cholecystectomy

INTRODUCTION: The role of laboratory biomarkers for predicting adverse clinical outcomes after laparoscopic cholecystectomy is unclear. This study aimed to investigate the potential biomarkers for predicting admission to intensive care unit (ICU) in patients who underwent laparoscopic cholecystectomy.
METHODS: All patients over 18 years old that underwent successful laparoscopic cholecystectomy between February 20, 2019, and June 15, 2021, at Ankara City Hospital Department of General Surgery were included in the study. The main outcome of the study was unplanned admission to ICU after laparoscopic cholecystectomy. Stata statistical package program (version 15.1/IC; StataCorp) was used to perform all data analyses.
RESULTS: Of 877 patients that were included in the current study, 76 (8.6%) were admitted to ICU. Multivariable logistic regression analysis revealed that lower levels of potassium (odds ratio [OR]: 0.206; 95% confidence interval [CI]: 0.109–0.388; p<0.001) and higher levels of monocyte (OR: 3.145; 95% CI: 1.472–6.715; p=0.003), total bilirubin (OR: 1.002; 95% CI: 1.001–1.003; p<0.001) and neutrophil (OR: 1.171; 95% CI: 1.102–1.244; p<0.001) were independently associated with an increased risk of admission to ICU. The accuracy of predicting ICU admission was assessed by the area under the receiver operating characteristic curve which was = 0.83. A nomogram was developed with significant predictors (neutrophil, total bilirubin, monocyte, and potassium) for the admission ICU.
DISCUSSION AND CONCLUSION: This is the first study investigating the role of laboratory parameters for predicting the need for ICU admission after laparoscopic cholecystectomy. If validated, this simple approach can contribute to the development of new personalized treatment strategies.