scholarly journals Compositional and drug-resistance profiling of pathogens in patients with severe acute pancreatitis: a retrospective study

2020 ◽  
Author(s):  
Ning Fan ◽  
Yong Hu ◽  
Hong Shen ◽  
Shengjie Liu ◽  
Guang Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Bacterial Infection ◽  
Drug Resistant ◽  
Bacterial Strains ◽  
Unconditional Logistic Regression ◽  
Gram Positive ◽  
Gram Negative

Abstract Background: Infection is one of the important causes of death in patients with severe acute pancreatitis (SAP) , but the bacterial spectrum and antibiotic resistance are constantly changing. Making good use of antibiotics and controlling multi-drug-resistant (MDR) bacterial infections are of vital importance in improving the cure rate of SAP. We conducted a retrospective study in the hope of providing references for antibiotic selection and control of drug-resistant bacteria. Methods: Retrospective analysis was performed on the data of patients hospitalized in our hospital due to acute pancreatitis (AP) in the past 5 years. General data were classified and statistically analyzed. Subsequently, the bacterial spectrum characteristics and the data related to drug-resistant bacterial infection of 569 AP patients were analyzed. Finally, unconditional logistic regression analysis was conducted to analyze the risk factors of MDR infection. Results: A total of 398 patients were enrolled in this study and the hospitalization data and associated results were analyzed. A total of 461 strains of pathogenic bacteria were detected, including 223 (48.4%) gram-negative bacterial strains, 190 (41.2%) gram-positive bacterial strains and 48 (10.4%) fungal strains. The detection rates of resistance in gram-negative and gram-positive bacterial strains were 48.0% (107/223) and 25.3% (48/190), respectively. There were significant differences between the MDR group and the non-MDR group for the factors of precautionary antibiotic use, kinds of antibiotics used, receipt of carbapenem, tracheal intubation, hemofiltration and number of hospitalization days in the intensive care unit. Unconditional logistic regression revealed 2 risk factors for MDR bacterial infection. Conclusions: Our results illustrate that gram-negative bacteria were the most common pathogens in SAP infection, and the proportion of gram-positive bacteria increased notably. The rate of antibiotic resistance was higher than previously reported. Unconditional logistic regression analysis showed that using more types of antibiotics and the number of hospitalization days in the ICU were the risk factors associated with MDR bacterial infection.

scholarly journals Compositional and drug-resistance profiling of pathogens in patients with severe acute pancreatitis: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ning Fan ◽  
Yong Hu ◽  
Hong Shen ◽  
Shengjie Liu ◽  
Guang Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Bacterial Infection ◽  
Drug Resistant ◽  
Bacterial Strains ◽  
Unconditional Logistic Regression ◽  
Gram Positive ◽  
Gram Negative

Abstract Background Infection is one of the important causes of death in patients with severe acute pancreatitis (SAP), but the bacterial spectrum and antibiotic resistance are constantly changing. Making good use of antibiotics and controlling multi-drug-resistant (MDR) bacterial infections are of vital importance in improving the cure rate of SAP. We conducted a retrospective study in the hope of providing references for antibiotic selection and control of drug-resistant bacteria. Methods Retrospective analysis was performed on the data of patients hospitalized in our hospital due to acute pancreatitis (AP) in the past 5 years. General data were classified and statistically analyzed. Subsequently, the bacterial spectrum characteristics and the data related to drug-resistant bacterial infection of 569 AP patients were analyzed. Finally, unconditional logistic regression analysis was conducted to analyze the risk factors of MDR infection. Results A total of 398 patients were enrolled in this study and the hospitalization data and associated results were analyzed. A total of 461 strains of pathogenic bacteria were detected, including 223 (48.4%) gram-negative bacterial strains, 190 (41.2%) gram-positive bacterial strains and 48 (10.4%) fungal strains. The detection rates of resistance in gram-negative and gram-positive bacterial strains were 48.0% (107/223) and 25.3% (48/190), respectively. There were significant differences between the MDR group and the non-MDR group for the factors of precautionary antibiotic use, kinds of antibiotics used, receipt of carbapenem, tracheal intubation, hemofiltration and number of hospitalization days in the intensive care unit. Unconditional logistic regression revealed 2 risk factors for MDR bacterial infection. Conclusions Our results illustrate that gram-negative bacteria were the most common pathogens in SAP infection, and the proportion of gram-positive bacteria increased notably. The rate of antibiotic resistance was higher than previously reported. Unconditional logistic regression analysis showed that using more types of antibiotics and the number of hospitalization days in the ICU were the risk factors associated with MDR bacterial infection.

scholarly journals Compositional and Drug-Resistance Profiling of Pathogens in Patients with Severe Acute Pancreatitis

2020 ◽  
Author(s):  
Ning Fan ◽  
Yong Hu ◽  
Shengjie Liu ◽  
Guang Zhao ◽  
Lanju Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Antibiotic Resistance ◽  
Bacterial Infection ◽  
Severe Acute Pancreatitis ◽  
Bacterial Strains ◽  
Unconditional Logistic Regression ◽  
Gram Positive ◽  
Gram Negative

Abstract Background: Infection is one of the important causes of death in patients with severe acute pancreatitis (SAP), but the bacterial spectrum and antibiotic resistance are constantly changing. Making good use of antibiotics and controlling multi-drug-resistant (MDR) bacterial infections are important steps in improving the cure rate of SAP.Methods: A total of 171 patients were enrolled in this study; the abdominal drainage fluid, sputum, blood, bile, deep venous catheter and urine of patients were cultured, identified and tested for resistance with a blood culture apparatus and microbiological analyzer. The associated results and hospitalization data were analyzed. Results: A total of 461 strains of pathogenic bacteria were detected, including 223 (48.4%) gram-negative bacterial strains, 190 (41.2%) gram-positive bacterial strains and 48 (10.4%) fungal strains. The detection rates of resistance in gram-negative and gram-positive bacterial strains were 48.0% (107/223) and 25.3% (48/190), respectively. There were significant differences between the MDR group and the non-MDR group for the factors of precautionary antibiotic use, kinds of antibiotics used, receipt of carbapenem, tracheal intubation, hemofiltration and number of hospitalization days in the intensive care unit. Unconditional logistic regression revealed 2 risk factors for MDR bacterial infection. Conclusions: Our results illustrate that gram-negative bacteria were the most common pathogens in SAP infection, and the proportion of gram-positive bacteria increased notably. The rate of antibiotic resistance was higher than previously reported. Unconditional logistic regression analysis showed that using more types of antibiotics and the number of hospitalization days in the ICU were the risk factors associated with MDR bacterial infection.

scholarly journals Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

2022 ◽  
Author(s):  
Chengcheng Sheng ◽  
Zongxu Xu ◽  
Jun Wang
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Organ Failure ◽  
Multivariate Logistic Regression Analysis ◽  
Concordance Index ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors ◽  
In Pregnancy

Abstract Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

scholarly journals Diabetes and Younger Age Are Vital and Independent Risk Factors for Acute Pancreatitis in Patients with Severe Hypertriglyceridemia

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Qiang Li ◽  
Chaoqun Hou ◽  
Yunpeng Peng ◽  
Xiaole Zhu ◽  
Chenyuan Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Hypertriglyceridemia ◽  
Younger Age ◽  
History Of ◽  
Independent Risk Factors

Background. The incidence of hypertriglyceridemia-induced acute pancreatitis (HIAP) is increasing worldwide, and now it is the third leading cause of acute pancreatitis in the United States. But, there are only 5% of patients with severe hypertriglyceridemia (>1000 mg/dl) which might generate acute pancreatitis. In order to explore which part of the patients is easy to develop into pancreatitis, a case-control study was performed by us to consider which patient population tend to develop acute pancreatitis in patients with severe hypertriglyceridemia. To perform a retrospective case-control study, we identified severe hypertriglyceridemia patients without AP (HNAP) and with HIAP with a fasting triglyceride level of >1000 mg/dl from The First Affiliated Hospital of Nanjing Medical University during January 1, 2014, to December 31, 2016. Baseline patient characteristics, comorbidities, and risk factors were recorded and evaluated by the univariate and multivariate logistic regression analysis for HIAP and HNAP patients. A total of 124 patients with severe hypertriglyceridemia were included in this study; of which, 62 patients were in the HIAP group and 62 were in the HNAP group. Univariate logistic regression analysis showed that there was no gender difference in both groups; however, there were more younger patients in the HIAP group than in the HNAP group (P value < 0.001), and the HIAP group had low level of high-density lipoprotein compared to the HNAP group (P<0.05). Meanwhile, the presence of pancreatitis was associated with higher level of glycemia and a history of diabetes (P<0.05). Multivariate logistic regression analysis indicated that a history of diabetes and younger age were independent risk factors for acute pancreatitis in patients with severe hypertriglyceridemia. Uncontrolled diabetes and younger age are potential risk factors in patients with severe hypertriglyceridemia to develop acute pancreatitis.

scholarly journals Design and validation of a scoring system for rapid identification of severe acute pancreatitis in patients with acute pancreatitis

2020 ◽  
Author(s):  
Ling Wang ◽  
Shaohong Wang ◽  
Jingguo Zhang
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Roc Curve ◽  
Scoring System ◽  
Rapid Identification ◽  
Cutoff Values ◽  
History Of

Abstract Purpose: Early identification of SAP and take necessary treatment can reduce the mortality rate of patients with AP. This study aimed to design a scoring system for rapid identification of SAP (RISAP) and evaluate its performance in predicting SAP in patients with AP. Methods: In the first phase, 1024 patients with AP who were admitted to the people's hospital of Qiandongnan Miao and Dong Autonomous Prefecture ,The Second Affiliated Hospital of Guizhou Medical University,the First People's Hospital of Kaili from January 2015 to June 2017 were included. Easily obtained indicators including patients’ gender, age, previous history of pancreatitis, acute diffuse peritonitis (ADP), pleural effusion (PE), heart rate (HR), respiratory rate (RR), and systolic blood pressure (SBP) measured under adequate analgesia, quietness conditions at admission were selected. Logistic regression analysis was performed to identify the risk factors for SAP. After determination of the cutoff values of the identified risk factors using ROC curve analysis, RISAP scoring system was designed. In the second phase, a total of 740 patients with AP who were admitted to our hospital from July 2017 to October 2019 were included and divided into SAP and non-SAP groups. RISAP, RANSON and BISAP scores were measured and compared between groups. The ROC curve was draw to analyze the ability of RISAP score in predicting SAP. Results: The number of patients who had history of pancreatitis,ADP, PE, HR, BR were significantly higher in the SAP group than in the non-SAP group (P <0.05). Logistic regression analysis showed that PE, HR, and RR were independent risk factors for SAP. Then RISAP score was designed based on the cutoff values of the three risk factors (0.5, 95.5, 22.5, respectively). The RISA, RANSON, and BISAP scores were significantly higher in the SAP group than that in the non-SAP group (U = -9.501,-3.701, -8.520 P <0.05). Compared with the RANSON, and BISAP scores, RISAP had the highest AUC values, sensitivity and specificity. Conclusion: The designed RISAP score is simple, convenient, economical, non-invasive, and highly repeatable, which is superior in rapid identification of SAP in patients with AP.

Risk Factors for Polymyxin B-associated Acute Kidney Injury in Patients with Severe Gram-Negative Bacterial Infections

2021 ◽  
Author(s):  
Ying Xu ◽  
Pei Liang ◽  
Ning Liu ◽  
Danjiang Dong ◽  
Jian Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Renal Function ◽  
Regression Analysis ◽  
Bacterial Infections ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Polymyxin B ◽  
Multivariate Logistic Regression ◽  
Gram Negative

Abstract BackgroundThe occurrence of polymyxin B-associated kidney injury (AKI) has been reported in recent years. The purpose of this study was to investigate the risk factors for polymyxin B-associated AKI and renal function recovery in patients with severe gram-negative bacterial infections.MethodsWe conducted a retrospective review of all severe gram-negative bacterial infection patients treated with polymyxin B admitted to Nanjing Drum Tower Hospital, a tertiary hospital in Nanjing City, China, between December 2018 and May 2021. Based on the new onset of AKI within 1 week after polymyxin B treatment, patients were divided into two groups: the AKI group and the non-AKI group. Among the AKI group, the patients were divided into an AKI recovery group and a nonrecovery AKI group according to the recovery of renal function within one week of polymyxin B discontinuation. Clinical manifestations, laboratory findings, treatments and outcomes in these patients were collected and analysed.ResultsA total of 188 cases were included. There were 87 cases in the AKI group (46.3%) and 101 cases in the non-AKI group (53.7%). Compared with the non-AKI group, the proportions of hypertension, shock and bacteremia were significantly higher in the AKI group (P < 0.05). In the AKI group, the platelet count was significantly decreased (P < 0.05), while the serum creatinine (Scr) of the AKI group was dramatically higher than that of the non-AKI group (P< 0.001). Compared with the non-AKI group, the loading dose and daily dose of polymyxin B in the AKI group were obviously higher (P< 0.05). The proportion of polymyxin + carbapenems in the AKI group was significantly elevated compared with that in the non-AKI group (P<0.05). The 28-d mortality in the AKI group was significantly higher than that in the non-AKI group (P<0.05). Multivariate logistic regression analysis indicated that cardiopulmonary resuscitation (CPR) history and baseline Scr ≥60 µmol/L before polymyxin B administration were independent risk factors for AKI (P<0.05). Fifty-nine patients met the criteria for AKI recovery analysis from the AKI group. There were 27 cases of unrecovered AKI (45.8%) and 32 cases of recovered AKI (54.2%). Multivariate logistic regression analysis identified male sex as an independent predictor for unrecovered AKI in patients with polymyxin B treatment.ConclusionsPolymyxin B-associated AKI occurs frequently in patients with severe gram-negative bacterial infection, and some patients cannot recover within one week after discontinuation of polymyxin B. Scr≥60 µmol/L before medication was found to be the only independent risk factor for polymyxin B-associated AKI, and it was more difficult for male patients to recover from AKI.

Antimicrobial Activity of Iron-Halide Complexes Against Gram-Positive and Gram-Negative Bacteria

2020 ◽  
Author(s):  
Nusrat Abedin ◽  
Abdullah Hamed A Alshehri ◽  
Ali M A Almughrbi ◽  
Olivia Moore ◽  
Sheikh Alyza ◽  
...  
Keyword(s):  
Antimicrobial Activity ◽  
Antimicrobial Resistance ◽  
Extracellular Dna ◽  
Antibiofilm Activity ◽  
Gram Negative Bacteria ◽  
Bacterial Strains ◽  
Gram Positive ◽  
Gram Negative ◽  
Antimicrobial Substances ◽  
Mammalian Cell Lines

Antimicrobial resistance (AMR) has become one of the more serious threats to the global health. The emergence of bacteria resistant to antimicrobial substances decreases the potencies of current antibiotics. Consequently, there is an urgent and growing need for the developing of new classes of antibiotics. Three prepared novel iron complexes have a broad-spectrum antimicrobial activity with minimum bactericidal concentration (MBC) values ranging from 3.5 to 10 mM and 3.5 to 40 mM against Gram-positive and Gram-negative bacteria with antimicrobial resistance phenotype, respectively. Time-kill studies and quantification of the extracellular DNA confirmed the bacteriolytic mode of action of the iron-halide compounds. Additionally, the novel complexes showed significant antibiofilm activity against the tested pathogenic bacterial strains at concentrations lower than the MBC. The cytotoxic effect of the complexes on different mammalian cell lines show sub-cytotoxic values at concentrations lower than the minimum bactericidal concentrations.

Risk Factors of Recurrent Ischemic Events after Acute Noncardiogenic Ischemic Stroke

2020 ◽  
Vol 25 (45) ◽  
pp. 4827-4834 ◽  
Author(s):  
Limin Zhang ◽  
Xingang Li ◽  
Dongzhi Wang ◽  
Hong Lv ◽  
Xuezhong Si ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Control Group ◽  
Case Group ◽  
Stroke Patients ◽  
Clopidogrel Therapy ◽  
Ischemic Events

Background: A considerable proportion of acute noncardiogenic ischemic stroke patients continue to experience recurrent ischemic events after standard therapy. Aim: We aimed to identify risk factors for recurrent ischemic event prediction at an early stage. Methods : 286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group (patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events was determined by the receiver operating characteristic curve and multivariable logistic regression analysis. Results: Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that MPV, ADP% and MA were indeed predictive factors. Conclusion: MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as possible.

scholarly journals Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Failure ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Tissue Expansion ◽  
Multivariate Logistic Regression ◽  
Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p &lt; 0.001), larger volume of expander (200–400 ml vs &lt;200 ml; OR, 1.74; p = 0.032; &gt;400 ml vs &lt;200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of &lt;1 year, expander volume of &gt;200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

Characteristics of Adenocarcinoma of the Gallbladder Following Cholecystectomies in the Hispanic Population

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S64-S65
Author(s):  
David Gustafson ◽  
Osvaldo Padilla
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Incidental Finding ◽  
Conditional Logistic Regression ◽  
Gallbladder Disease ◽  
Predictor Variables ◽  
Wall Thickening ◽  
Conditional Logistic Regression Analysis

Abstract Introduction Gallbladder adenocarcinoma (GBC) is a rare malignancy. Frequency of incidental adenocarcinoma of the gallbladder in the literature is approximately 0.2% to 3%. Typically, GBC is the most common type and is discovered late, not until significant symptoms develop. Common symptoms include right upper quadrant pain, nausea, anorexia, and jaundice. A number of risk factors in the literature are noted for GBC. These risk factors are also more prevalent in Hispanic populations. This study sought to compare patients with incidental gallbladder adenocarcinomas (IGBC) to those with high preoperative suspicion for GBC. Predictor variables included age, sex, ethnicity, radiologic wall thickening, gross pathology characteristics (wall thickness, stone size, stone number, and tumor size), histologic grade, and staging. Methods Cases of GBC were retrospectively analyzed from 2009 through 2017, yielding 21 cases. Data were collected via Cerner EMR of predictor variables noted above. Statistical analysis utilized conditional logistic regression analysis. Results The majority of patients were female (n = 20) and Hispanic (n = 19). There were 14 IGBCs and 7 nonincidental GBCs. In contrast with previous research, exact conditional logistic regression analysis revealed no statistically significant findings. For every one-unit increase in AJCC TNM staging, there was a nonsignificant 73% reduction in odds (OR = 0.27) of an incidental finding of gallbladder carcinoma. Conclusion This study is important in that it attempts to expand existing literature regarding a rare type of cancer in a unique population, one particularly affected by gallbladder disease. Further studies are needed to increase predictive knowledge of this cancer. Longer studies are needed to examine how predictive power affects patient outcomes. This study reinforces the need for routine pathologic examination of cholecystectomy specimens for cholelithiasis.

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