{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:55:19Z","timestamp":1793393719092,"version":"4.5.0"},"reference-count":36,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100016220","name":"Georgia Clinical and Translational Science Alliance","doi-asserted-by":"publisher","award":["KL2 TR000136"],"award-info":[{"award-number":["KL2 TR000136"]}],"id":[{"id":"10.13039\/100016220","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","surgjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgery"],"published-print":{"date-parts":[[2018,4]]},"DOI":"10.1016\/j.surg.2017.10.041","type":"journal-article","created":{"date-parts":[[2018,1,8]],"date-time":"2018-01-08T10:06:20Z","timestamp":1515405980000},"page":"739-746","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":56,"title":["Validation of the AAST EGS acute cholecystitis grade and comparison with the Tokyo guidelines"],"prefix":"10.1016","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8084-9685","authenticated-orcid":false,"given":"Matthew","family":"Hernandez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan M.","family":"Aho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeem N.","family":"Haddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humza","family":"Saleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Zeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald H.","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zielinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2017.10.041_bib0010","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1097\/TA.0b013e3182aafdba","article-title":"Measuring anatomic severity of disease in emergency general surgery","volume":"76","author":"Shafi","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"issue":"6","key":"10.1016\/j.surg.2017.10.041_bib0015","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD010326","article-title":"Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis","author":"Gurusamy","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.surg.2017.10.041_bib0020","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1007\/s11605-015-2747-x","article-title":"Early cholecystectomy is superior to delayed cholecystectomy for acute cholecystitis: a meta-analysis","volume":"19","author":"Cao","year":"2015","journal-title":"J Gastrointest Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0025","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00464-007-9511-6","article-title":"Laparoscopic cholecystectomy for severe acute cholecystitis. A meta-analysis of results","volume":"22","author":"Borzellino","year":"2008","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2017.10.041_bib0030","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1097\/TA.0000000000000832","article-title":"Gangrenous cholecystitis","volume":"79","author":"Yeh","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0035","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1749-7922-6-44","article-title":"The need for new \u201cpatient-related\u201d guidelines for the treatment of acute cholecystitis","volume":"6","author":"Campanile","year":"2011","journal-title":"World J Emerg Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0040","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00534-006-1159-4","article-title":"Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines","volume":"14","author":"Hirota","year":"2007","journal-title":"J Hepatobiliary Pancreat Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0045","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00534-006-1152-y","article-title":"Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines","volume":"14","author":"Kimura","year":"2007","journal-title":"J Hepatobiliary Pancreat Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0050","doi-asserted-by":"crossref","first-page":"249","DOI":"10.7888\/juoeh.35.249","article-title":"Progression of Tokyo guidelines and Japanese guidelines for management of acute cholangitis and cholecystitis","volume":"35","author":"Mayumi","year":"2013","journal-title":"J UOEH"},{"key":"10.1016\/j.surg.2017.10.041_bib0055","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1007\/s00534-012-0548-0","article-title":"New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo Guidelines","volume":"19","author":"Yokoe","year":"2012","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"10.1016\/j.surg.2017.10.041_bib0060","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s00534-006-1161-x","article-title":"Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines","volume":"14","author":"Yamashita","year":"2007","journal-title":"J Hepatobiliary Pancreat Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0065","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1007\/s00534-012-0536-4","article-title":"Changes in the therapeutic strategy for acute cholecystitis after the Tokyo Guidelines were published","volume":"20","author":"Asai","year":"2013","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"10.1016\/j.surg.2017.10.041_bib0070","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.kjms.2014.05.005","article-title":"Assessing clinical outcomes of patients with acute calculous cholecystitis in addition to the Tokyo grading: a retrospective study","volume":"30","author":"Cheng","year":"2014","journal-title":"Kaohsiung J Med Sci"},{"key":"10.1016\/j.surg.2017.10.041_bib0075","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/7675953","article-title":"Factor analysis influencing postoperative hospital stay and medical costs for patients with definite, suspected, or unmatched diagnosis of acute cholecystitis according to the Tokyo Guidelines 2013","volume":"2016","author":"Hayasaki","year":"2016","journal-title":"Gastroenterol Res Pract"},{"key":"10.1016\/j.surg.2017.10.041_bib0080","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/TA.0000000000001127","article-title":"The American Association for the Surgery of Trauma Grading Scale for 16 Emergency General Surgery Conditions","volume":"81","author":"Tominaga","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0085","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1097\/TA.0000000000000444","article-title":"Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical illnesses","volume":"77","author":"Crandall","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0090","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jss.2015.03.036","article-title":"Validating a new grading scale for emergency general surgery diseases","volume":"196","author":"Savage","year":"2015","journal-title":"J Surg Res"},{"key":"10.1016\/j.surg.2017.10.041_bib0095","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/TA.0000000000000943","article-title":"Multicenter validation of American Association for the Surgery of Trauma Grading System for acute colonic diverticulitis and its use for emergency general surgery quality improvement program","volume":"80","author":"Shafi","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0100","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/TA.0000000000001274","article-title":"Increased anatomic severity predicts outcomes: validation of the American Association for the Surgery of Trauma's emergency general surgery score in appendicitis","volume":"82","author":"Hernandez","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0105","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/TA.0000000000001422","article-title":"Increased anatomic severity in appendicitis is associated with outcomes in a South African population","volume":"83","author":"Hernandez","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0110","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1097\/TA.0000000000000608","article-title":"ICD-9-CM and ICD-10-CM mapping of the AAST Emergency General Surgery disease severity grading systems: conceptual approach, limitations, and recommendations for the future","volume":"78","author":"Utter","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0115","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.jamcollsurg.2013.07.385","article-title":"Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons","volume":"217","author":"Bilimoria","year":"2013","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0120","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"Clavien","year":"2009","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0125","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00534-012-0568-9","article-title":"TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)","volume":"20","author":"Yokoe","year":"2013","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"10.1016\/j.surg.2017.10.041_bib0130","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","article-title":"The meaning and use of the area under a receiver operating characteristic (ROC) curve","volume":"143","author":"Hanley","year":"1982","journal-title":"Radiology"},{"key":"10.1016\/j.surg.2017.10.041_bib0135","doi-asserted-by":"crossref","first-page":"e160480","DOI":"10.1001\/jamasurg.2016.0480","article-title":"Use of national burden to define operative emergency general surgery","volume":"2115","author":"Scott","year":"2016","journal-title":"JAMA Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0140","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1097\/TA.0000000000000555","article-title":"National estimates of predictors of outcomes for emergency general surgery","volume":"78","author":"Shah","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0145","doi-asserted-by":"crossref","first-page":"2892","DOI":"10.1007\/s00268-016-3660-5","article-title":"The yield of fever, inflammatory markers and ultrasound in the diagnosis of acute cholecystitis: a validation of the 2013 Tokyo Guidelines","volume":"40","author":"Naidu","year":"2016","journal-title":"World J Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0150","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12876-015-0365-4","article-title":"Does the Tokyo guidelines predict the extent of gallbladder inflammation in patients with acute cholecystitis? A single center retrospective analysis","volume":"15","author":"Ambe","year":"2015","journal-title":"BMC Gastroenterol"},{"key":"10.1016\/j.surg.2017.10.041_bib0155","doi-asserted-by":"crossref","first-page":"2892","DOI":"10.1007\/s00464-016-5300-4","article-title":"Tokyo Guidelines 2013 may be too restrictive and patients with moderate and severe acute cholecystitis can be managed by early cholecystectomy too","volume":"31","author":"Amirthalingam","year":"2016","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2017.10.041_bib0160","doi-asserted-by":"crossref","first-page":"3858","DOI":"10.1007\/s00464-016-5412-x","article-title":"The optimal treatment of patients with mild and moderate acute cholecystitis: time for a revision of the Tokyo Guidelines","volume":"31","author":"Loozen","year":"2017","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2017.10.041_bib0165","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/TA.0000000000001312","article-title":"Surgical rescue: the next pillar of acute care surgery","volume":"82","author":"Kutcher","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0170","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/TA.0000000000000787","article-title":"The financial burden of emergency general surgery: national estimates 2010 to 2060","volume":"79","author":"Ogola","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0175","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/TA.0000000000000911","article-title":"Cost of specific emergency general surgery diseases and factors associated with high-cost patients","volume":"80","author":"Ogola","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0180","first-page":"2","article-title":"Postoperative complications of laparoscopic cholecystectomy for acute cholecystitis: a comparison to the ACS-NSQIP risk calculator and the Tokyo Guidelines","volume":"41","author":"Massoumi","year":"2016","journal-title":"World J Surg"},{"key":"10.1016\/j.surg.2017.10.041_bib0185","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.jamcollsurg.2016.12.021","article-title":"Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis","volume":"224","author":"Dimou","year":"2017","journal-title":"J Am Coll Surg"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606017307791?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606017307791?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T10:51:37Z","timestamp":1758538297000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0039606017307791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["S0039606017307791"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2017.10.041","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2018,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Validation of the AAST EGS acute cholecystitis grade and comparison with the Tokyo guidelines","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2017.10.041","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}