{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:14:44Z","timestamp":1778516084131,"version":"3.51.4"},"reference-count":13,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Acute cholecystitis is one of the most common acute diseases of the biliary system and a frequent reason for emergency hospital admission and surgical treatment. More severe forms are associated with a higher need for intensive care, more frequent use of open surgery, and less favourable outcomes. Age and chronic comorbidity burden may play an important role in determining disease severity. The age-adjusted Charlson Comorbidity Index (CCI-Age) is a simple and widely used tool for integrated assessment of age and comorbidity burden, but its role in acute cholecystitis is not sufficiently defined. Methods: Data for this study were collected by retrospective analysis of hospital records from the hospital information system of the University Hospital Centre Zagreb. Patients treated conservatively were excluded. The association of age and CCI-Age with the severity of the clinical presentation of acute cholecystitis was analysed using dichotomised clinical variables and comparative statistical methods. Results: The results showed that age and the presence of chronic diseases were strongly associated with the severity of the clinical presentation of acute cholecystitis. Older patients and those with a greater burden of chronic comorbidities significantly more often developed more severe forms of the disease. Among chronic diseases, peripheral vascular disease, diabetes mellitus, and chronic renal disease showed the strongest association with more severe clinical presentation. Conclusions: Age and CCI-Age were strongly associated with the severity of the clinical presentation of acute cholecystitis. CCI-Age may represent a useful tool for early clinical risk stratification and support therapeutic decision making in everyday surgical practice.<\/jats:p>","DOI":"10.3390\/diagnostics16101462","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:39:32Z","timestamp":1778513972000},"page":"1462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-Adjusted Charlson Comorbidity Index as a Predictor of Clinical Severity in Acute Cholecystitis: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Marin","family":"Davidovi\u0107","sequence":"first","affiliation":[{"name":"Department of Gastroenteral and Oncologic Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juraj","family":"Kolak","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Organ Transplantation, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0373-6501","authenticated-orcid":false,"given":"Josip","family":"Basi\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Zenko Sever","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucija","family":"Brki\u0107","sequence":"additional","affiliation":[{"name":"Department of Gastroenteral and Oncologic Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3807-9163","authenticated-orcid":false,"given":"Barbara","family":"Kolak","sequence":"additional","affiliation":[{"name":"Health Center Zagreb\u2014Center, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9642-3774","authenticated-orcid":false,"given":"Igor","family":"Petrovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Organ Transplantation, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hrvoje","family":"Silovski","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Organ Transplantation, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/jhbp.515","article-title":"Tokyo Guidelines 2018: Diagnostic criteria and severity grading of acute cholecystitis","volume":"25","author":"Yokoe","year":"2018","journal-title":"J. Hepato-Biliary-Pancreat. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13017-016-0082-5","article-title":"2016 WSES guidelines on acute calculous cholecystitis","volume":"11","author":"Ansaloni","year":"2016","journal-title":"World J. Emerg. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2804","DOI":"10.1056\/NEJMcp0800929","article-title":"Acute calculous cholecystitis","volume":"358","author":"Strasberg","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/TA.0000000000000457","article-title":"Using the age-adjusted Charlson comorbidity index to predict outcomes in emergency general surgery","volume":"78","author":"Iqbal","year":"2015","journal-title":"J. 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Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"k3965","DOI":"10.1136\/bmj.k3965","article-title":"Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high-risk patients (CHOCOLATE): Multicentre randomised clinical trial","volume":"363","author":"Loozen","year":"2018","journal-title":"BMJ"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/10\/1462\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:55:49Z","timestamp":1778514949000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/10\/1462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":13,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["diagnostics16101462"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16101462","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]}}}