PREOP-Gallstones Nomogram of Parmar et al for Evaluating an Older Adult with Cholelithiasis

Description

Parmar et al developed the PREOP (Predicting Risk of Complications in Older Patients with) Gallstones nomogram to evaluate older patients with cholelithiasis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Texas Medical Branch at Galveston and the University of California at San Francisco.

Patient selection: adult >= 66 years of age with cholethiasis

Outcome: probability of emergent visit within the next 12 months

Parameters:

(1) gender of the patient

(2) diagnostic group

(3) Elixhauser comorbidity index

(4) age group

(5) race

(6) visit type

Parameter	Finding	Points
gender	male	0
	female	6.5
diagnostic group	biliary colic	0
	acute cholecystitis	48.5
	common bile duct stone	56.4
	gallstone pancreatitis	100
comorbidity	>= 3	0
	2	3.2
	1	6.6
	0	10.7
age group	66 to 69	0
	70 to 74	0.5
	75 to 79	6.6
	>= 80	7.1
race	Hispanic	0
	black	15.5
	white	18.1
	other	10.4
visit type	physician office	0
	emergent	70

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 212.4

• The higher the score the more likely that the patient will have an emergency visit within the next 12 months.

Points	Probability
< 42	< 10%
42 to 212.4	(0.001518 * ((points)^2)) + (0.1175 * (points)) + 1.1116

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Description

Specialty

ICD-10