The Cholecystectomy As A Day Case (CAAD) score: a validated score of preoperative predictors of successful day-case cholecystectomy using the CholeS data set

Background: Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods: Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results: Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions: The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

The Early Bronze Age axeheads of central and southern England

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Measurement of J/Ψ production in pp collisions at √s=7 TeV

The production of J/psi mesons in proton-proton collisions at root s = 7 TeV is studied with the LHCb detector at the LHC. The differential cross-section for prompt J/psi production is measured as a function of the J/psi transverse momentum p(T) and rapidity y in the fiducial region p(T) is an element of [0; 14] GeV/c and y is an element of [2.0; 4.5]. The differential cross-section and fraction of J/psi from b-hadron decays are also measured in the same p(T) and y ranges. The analysis is based on a data sample corresponding to an integrated luminosity of 5.2 pb(-1). The measured cross-sections integrated over the fiducial region are 10.52 +/- 0.04 +/- 1.40(-2.20)(+1.64) mu b for prompt J/psi production and 1.14 +/- 0.01 +/- 0.16 mu b for J/psi from b-hadron decays, where the first uncertainty is statistical and the second systematic. The prompt J/psi production cross-section is obtained assuming no J/psi polarisation and the third error indicates the acceptance uncertainty due to this assumption

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The Petters Late Bronze Age metalwork An analytical study of Thames Valley metalworking in its settlement context

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