Are Gallbladder Abnormalities in Critically Ill Patients Clinically Relevant? Insights from the Medical Intensive Care Unit of a Medical Center

Background: Gallbladder (GB) abnormalities are frequently observed in critically ill patients, but their clinical relevance remains uncertain. This study aimed to evaluate the prevalence of GB abnormalities and their association with clinical outcomes in patients admitted to a medical intensive care unit (ICU). Methods: We conducted a retrospective study of adult patients admitted to the medical ICU of Changhua Christian Hospital from February to September 2023 who underwent abdominal ultrasound. Patients with prior cholecystectomy or diagnosed acute cholecystitis were excluded. Clinical variables, ultrasound findings, and 30-day outcomes were analyzed. Results: A total of 59 patients were included (mean age 68.9 ± 14.7 years; 69.5% male). GB abnormalities were identified in 33 patients (55.9%), with wall thickening (35.6%) and pericholecystic fluid (30.5%) being most common. GB abnormalities were significantly associated with lower serum albumin (2.8 ± 0.5 vs. 3.3 ± 0.8 g/dL, P = 0.018) and prolonged nil per os status ( P = 0.002), but not with age, sex, acute physiology and chronic health evaluation II score, or 30-day mortality ( P = 0.980). Sludge was more frequent in patients with ICU stays ≥48 h (30.0% vs. 5.1%, P = 0.008). Conclusion: GB abnormalities are common among medical ICU patients and are associated with hypoalbuminemia and prolonged fasting, but not with increased short-term mortality. These findings may help guide clinical management and avoid unnecessary interventions.