Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
August 19, 2026ANZ Journal of SurgeryOpen Access

High-risk pMDRS stratification is linked to ~167% greater risk of prolonged hospital stay versus low-risk.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Existing preoperative risk stratification tools have limited predictive ability in older, comorbid patients with acute cholecystitis undergoing cholecystectomy.

Does the preoperative Multi Domain Risk Stratification (pMDRS) model predict post-operative outcomes in older patients with acute cholecystitis undergoing cholecystectomy?

Comparison

pMDRS-model low vs moderate vs high-risk groups

Design

Retrospective prognostic study

Key result

High-risk stratification using the pMDRS model was associated with an increased risk of prolonged hospital stay (IRR 2.67; 95% CI 1.38-5.17) compared to low-risk patients.

Authors

KWKate WyldeLFLeon FlickerSBSally Burrows

Discussion

Loading...

Member takes

Overview

pMDRS may aid risk stratification in older acute cholecystitis patients; leaves open prospective validation before adoption.

Key Points

  • To evaluate the predictive capability of the novel preoperative Multi Domain Risk Stratification (pMDRS) model for inpatient postoperative outcomes in older patients undergoing cholecystectomy for acute cholecystitis.
  • Retrospective prognostic study analyzing N=200 consecutive patients admitted to a tertiary surgical unit with acute cholecystitis who underwent cholecystectomy.
  • Applied the pMDRS model to categorize patients into low, moderate, and high-risk groups, using multivariable regression adjusted for age, sex, comorbidities, and surgical approach to assess outcomes.
  • Hospital length of stay was significantly longer for the high-risk group (incidence rate ratio [IRR] 2.67, 95% CI 1.38–5.17) and moderate-risk group (IRR 1.90, 95% CI 1.16–3.11) compared to the low-risk group.
  • Higher risk tiers exhibited increased odds of medical complications (high-risk: OR 5.37, 95% CI 1.05–28.03; moderate-risk: OR 2.73, 95% CI 1.27–6.45) and Medical Emergency Team calls (high-risk: OR 24.28, 95% CI 2.96–198.93; moderate-risk: OR 7.10, 95% CI 1.29–38.96), while surgical complications showed no significant difference after adjustment (high-risk: OR 1.60, 95% CI 0.40–6.38).

Study Design

Type

Observational (n=200)

Multicenter

No

Structured PICO

Does the preoperative Multi Domain Risk Stratification (pMDRS) model predict post-operative outcomes in older patients with acute cholecystitis undergoing cholecystectomy?

P
Population
200 consecutive older patients with acute cholecystitis who underwent cholecystectomy at a tertiary surgical unit.
E
Exposure
Preoperative Multi Domain Risk Stratification (pMDRS) model (high and moderate risk groups)
C
Comparator
Low-risk group according to the pMDRS model
O
Outcome
Post-operative outcomes including length of hospital stay, medical complications, surgical complications, and Medical Emergency Team calls

Main Result

Relative Risk: 2.67 (95% CI 1.38–5.17)

The pMDRS model effectively predicts length of stay and medical complications in older patients undergoing cholecystectomy for acute cholecystitis.

Limitations

  • A larger sample is required to evaluate the model's ability to predict mortality and functional outcomes.
  • Small sample size to evaluate mortality and functional outcomes

Cite This Study

Wylde et al. (2026) conducted an observational in Acute cholecystitis (n=200). High risk on the preoperative Multi Domain Risk Stratification (pMDRS) model vs. Low risk on the pMDRS model was evaluated on Prolonged hospital stay (IRR 2.67, 95% CI 1.38-5.17). High-risk stratification using the pMDRS model was associated with an increased risk of prolonged hospital stay (IRR 2.67; 95% CI 1.38-5.17) compared to low-risk patients.

synapsesocial.com/papers/6a8563eb03308d306e2d75d0https://doi.org/10.1111/ans.70918
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Predicting Postoperative Complications After Cholecystectomy for Acute Cholecystitis: Comparative Performance of Disease-Specific and General Prognostic Scores2026
  2. 2Early predictors of in-hospital mortality after percutaneous cholecystostomy2026
  3. 3Need for better risk models in very elderly surgery: evaluating ACS-NSQIP in patients = 85 years2026 · 1 citations
  4. 4Predictive value of biochemical markers and clinical scoring systems for outcomes in nonagenarians and centenarians admitted to the ICU after cholecystectomy for acute cholecystitis: a binational multicenter analysis2026
  5. 5Factors Associated with 30- and 90-Day Mortality After Percutaneous Cholecystostomy for Acute Cholecystitis: A Single-Centre Retrospective Cohort Study2026