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Table 2 Morbidity Score

From: Acute cholecystitis – early laparoskopic surgery versus antibiotic therapy and delayed elective cholecystectomy: ACDC-study

Persistent abdominal pain > 72 h 1 Pain treated by morphine or derivatives > 72 h
Persistent fever > 72 h 1 Rectal temperature > 38.5°C at least twice
Persistently raised signs of infection > 72 h 1 Persistently elevated CRP or leukocytosis
Wound-healing disorder 2 Any problem leading to re-opening of the wound with subsequent open wound treatment
Thrombosis 3 New onset of leg or pelvic thrombosis
Bleeding 3 Need for more than two bags of packed red cells during or after surgery
Cholangitis 3 New increase in AP, GGT (>2× ULN), bilirubin (>1× ULN) plus leukocytosis (> 12 × 103/μl) or increase in CRP (> 5× ULN)
Icterus 3 New increase in bilirubin, AP and GGT (>2× ULN)
Bile leakage 3 Persistent leakage shown by CT, MRI or ERCP
Abscess 3 Shown by CT, MRI or ultrasound
Pneumonia 3 Shown by X-ray plus drop in arterial pO2 plus clinical signs of pneumonia plus leukocytosis plus increased CRP
Embolic lung disease 4 Increased PA pressure (echocardiogram), TNT/TNI, D-dimers
Peritonitis 4 New occurrence of peritonitis
Pancreatitis 4 Increased pancreatic enzymes (> 3× ULN) plus new increase in CRP (> 5× ULN) plus positive clinical signs
Renal failure 4 Drop in urine production below 500 mL/day plus increased creatinine and urea (> 2× ULN)
Relaparotomy 5 Need for follow-up surgery
Cerebral ischemia or bleeding 5 New neurological symptoms with corresponding to changes in cerebral CT
Myocardial infarction 5 Changes in TNT/TNI with or without changes in the ECG meeting the criteria of STEMI of NSTEMI
Septic shock 5 Leukocytosis (> 12 × 103/μl) or leukopenia (< 4 × 103/μl) plus temperature < 36.5°C or > 38.5°C plus clinical signs
Death 63 (Sum of all complications + 1)
  1. Different complications and side effects that may affect the patients during the study are listed and scored differently in increasing severity. Death as worst outcome is scored the sum of all complications plus 1.