| Autor: |
Thunnissen FM; Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., Comes DJ; Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., Geenen RWF; Department of Radiology, Northwest Clinics, 1815 JD Alkmaar, The Netherlands., Riviere D; Department of Radiology, Jeroen Bosch Hospital, 5223 GZ 's-Hertogenbosch, The Netherlands., Latenstein CSS; Department of Surgery, Amsterdam UMC, Location VUMC, 1081 HV Amsterdam, The Netherlands., Lantinga MA; Department of Gastroenterology and Hepatology, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands., Schers HJ; Department of General Practice, Radboud Institute for Health Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., van Laarhoven CJHM; Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., Drenth JPH; Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., Atsma F; Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., de Reuver PR; Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. |
| Abstrakt: |
This study aimed to quantify the confirmation of gallstones on ultrasound (US) in patients with suspicion of gallstone disease. To aid general practitioners (GPs) in diagnostic workup, a model to predict gallstones was developed. A prospective cohort study was conducted in two Dutch general hospitals. Patients (≥18 years) were eligible for inclusion when referred by GPs for US with suspicion of gallstones. The primary outcome was the confirmation of gallstones on US. A multivariable regression model was developed to predict the presence of gallstones. In total, 177 patients were referred with a clinical suspicion of gallstones. Gallstones were found in 64 of 177 patients (36.2%). Patients with gallstones reported higher pain scores (VAS 8.0 vs. 6.0, p < 0.001), less frequent pain (21.9% vs. 54.9%, p < 0.001), and more often met criteria for biliary colic (62.5% vs. 44.2%, p = 0.023). Predictors for the presence of gallstones were a higher pain score, frequency of pain less than weekly, biliary colic, and an absence of heartburn. The model showed good discrimination between patients with and without gallstones (C-statistic 0.73, range: 0.68-0.76). Clinical diagnosis of symptomatic gallstone disease is challenging. The model developed in this study may aid in the selection of patients for referral and improve treatment related outcomes. |
