The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage

The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage Chi-Chih Wang, Ming-Hseng Tseng, Chun-Che Lin, Sheng-Wen Wu, Tzu-Wei Yang, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-16962/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 14 Feb, 2021 Read the published version in Frontiers in Surgery → Version 1 posted You are reading this latest preprint version Abstract Background Cholecystectomy (CCY) is the only definitive therapy for acute cholecystitis. We conducted this study to evaluate which patients may not benefit from further CCY after percutaneous transhepatic gallbladder drainage (PTGBD) has been performed in acute cholecystitis patients. Methods Acute cholecystitis patients with PTGBD treatment were selected from one million random samples from the National Health Insurance Research Database obtained between January 2004 and December 2010. Recurrent biliary events (RBEs), RBE-related medical costs, RBE-related mortality rate and an RBE-free survival curve were compared in patients who accepted CCY within 2 months and patients without CCY within 2 months after the index admission. Results 365 acute cholecystitis patients underwent PTGBD at the index admission. A total of 190 patients underwent further CCY within 2 months after the index admission. The other 175 patients did not accept further CCY within 2 months after the index admission. RBE-free survival was significantly better in the CCY within 2 months group (60% vs. 42%, p<0.001). The RBE-free survival of the CCY within 2 months group was similar to that of the no CCY within 2 months group in patients ≥ 80 years old and patients with a Charlson Comorbidity Index (CCI) score ≥ 9. Conclusion We confirmed CCY after PTGBD reduced RBEs, RBE-related medical expenses, and the RBE-related mortality rate in patients with acute cholecystitis. In patients who accepted PTGBD, the RBE and survival benefits of CCY within 2 months became insignificant in patients ≥ 80 years old or with a CCI score ≥ 9. Surgery gallbladder drainage cholecystectomy acute cholecystitis recurrent biliary event Figures Figure 1 Figure 2 Figure 3 Background: Cholelithiasis is one of the most popular diseases with increasing prevalence and substantial burden on healthcare resources [1, 2] . Because the abundant access to food worldwide increases the risk of obesity, the incidence rates of cholelithiasis grow accordingly [3, 4] . Cholecystitis refers to inflammation of the gallbladder, and it can be defined as acute or chronic cholecystitis by the duration of the disease. Acute acalculous cholecystitis accounts for only less than 10%[ 5 , 6 ] of all cholecystitis patients. Acute cholecystitis is a complication of gallstone disease and typically develops in patients with a history of symptomatic gallstones[ 7 , 8 ]. After the diagnosis of acute cholecystitis, evaluations of the disease severity are necessary[ 9 ] to guide clinical management, such as early cholecystectomy (CCY) or percutaneous transhepatic gallbladder drainage (PTGBD), especially in critically ill patients[ 10 , 11 ]. According to the timing of CCY, CCY can be further classified as early or delayed CCY, and early CCY is a better choice than delayed CCY in terms of hospital stay and the medical expenses of treatment[ 12 ] ,16 . Compared to delayed CCY, early CCY for cases within 72 hours of symptom onset was associated with lower mortality rates and complication rates in the majority of cases in previous literature[ 12 – 14 ]. Some references show that delayed CCY has a higher proportion of laparoscopy[ 15 ] and a lower complication rate[ 16 ]. Although CCY is the only definitive therapy for acute cholecystitis[ 9 , 17 , 18 ], there are patients who cannot tolerate or do not want surgical intervention despite the benefits of early or delayed CCY. Although the role of PTGBD in acute cholecystitis remains a debate[ 19 , 20 ] compared to conservative treatment, PTGBD is useful for managing high surgical risk patients and patients with severe comorbidities[ 9 , 21 , 22 ]. Currently, there is no strong evidence to suggest surgery timing after patients with acute cholecystitis have undergone PTGBD[ 23 – 25 ], but CCY could decrease the likelihood of recurrent biliary events (RBEs)[ 26 ] after successful PTGBD intervention in these patients. As a result, patients with acute cholecystitis, who were successfully treated by PTGBD, should accept further early, interval, or delayed CCY to prevent future RBEs. As our recognition, acute cholecystitis patients who have high comorbidity or were extremely old may not benefit from further CCY. We used the Charlson Comorbidity Index (CCI)[ 27 , 28 ] to represent the level of comorbidities in patients in our study, which obtained from the Taiwan National Health Insurance Research Database (NHIRD). There are no current guidelines for the optimal timing for performing CCY after PTGBD, and only few real-world studies suggest the timing of CCY[ 29 ] due to surgical complications. We attempted to evaluate the benefits of CCY after patients with acute cholecystitis underwent PTGBD and whether the benefits disappear due to severe comorbidities or old age in a retrospective database cohort study. Methods: Our study was approved by the Institutional Review Board (IRB) of Chung Shan Medical University Hospital in Taiwan. All methods were performed in accordance with the relevant regulations and under the surveillance of the IRB of Chung Shan Medical University Hospital. Study design This study was a population-based retrospective cohort study based on Taiwan’s NHIRD, which covers more than 99% of the entire population [30] . The NHIRD has been described in detail in previous studies[31-33]. Cholelithiasis cases were selected from one million random samples from the NHIRD between 2004 and 2011 using the codes of International Statistical Classification of Diseases and Related Health Problems, 9th Edition (ICD-9) recorded by emergency room (ER) visits or admissions. Patients with acute cholecystitis were selected using ICD-9 codes documented in 2004-2010 to ensure the follow-up period is more than one year, and then, we identified patients who underwent PTGBD (procedure code 33106B) during an index admission or during an ER course 3 days before admission. Patients who had previously undergone CCY or PTGBD between the index admission and 2004 were excluded. The observation period was selected from the index admission to December 2011 or the expired date of patients. A total of 365 patients with acute cholecystitis who underwent PTGBD were selected, and 190 of these patients accepted CCY within 2 months (60 days) after the index admission. The other 175 patients with acute cholecystitis who underwent PTGBD during the index admission did not accept CCY 2 months after the index admission. Twenty-five patients in the no CCY within 2 months group eventually underwent CCY during the follow-up period. We compared age, gender, baseline CCI score, the proportion of laparoscopic and open CCY procedures, the total follow-up time, time to events, RBEs, overall mortality, RBE-related mortality, and the total medical expenses for RBEs between these two groups. RBE-related mortality was defined as mortality events due to RBEs during hospitalization or within 5 days after discharge. The design of this study is shown in Figure 1. An economic analysis of the costs of the index admission, CCY events, ER visits and hospitalization due to RBEs, and the total medical expenses were compared between the CCY within 2 months group and the no CCY within 2 months group for patients with acute cholecystitis who initially underwent PTGBD under Taiwan’s national health insurance system. Data processing and statistical analysis The one million individuals who represent the nationwide population between 2004 and 2011 in Taiwan were processed using Microsoft SQL Server 2008 R2 (Microsoft Corporation, Redmond, WA, USA) with the SQL programming language. Statistical analysis was performed using OpenEpi: Open Source Epidemiologic Statistics for Public Health, version 3.01[34]. Kaplan–Meier survival analyses were conducted using SPSS version 19. The data obtained from the study were processed using Chi-Square (χ 2 ) tests for categorical variables, one-way analyses of variance (ANOVA) for continuous variables, and log-rank (Mantel–Cox) tests for disease-free survival curves. A two-tailed P-value of 0.05 was considered statistically significant. Results: A total 9,248 adult patients with acute cholecystitis were selected from one million samples from January 2004 to December 2011. Because the follow-up period should be at least one year, we included 377 acute cholecystitis patients who underwent PTGBD between January 2004 and December 2010. Twelve patients were excluded because of previous PTGBD before the index admission. The data for 365 acute cholecystitis patients who underwent PTGBD at the index admission were collected. A total of 190 patients with a mean age of 68.42 ± 13.17 years underwent further CCY within 2 months after the index admission. The other 175 patients, with a mean age of 72.67 ± 13.75 years, did not accept further CCY within 2 months after the index admission. The baseline CCI score, 5.77 ± 3.41 in the CCY within 2 months group and 7.79 ± 4.10 in the no CCY within 2 months group, was significantly higher in the no CCY group (p=0.01). As for the components of the CCI, the proportions of patients with congestive heart failure (10.53% vs. 25.14%, p<0.01), hemiplegia or paraplegia (0% vs. 3.43%, p=0.04), and chronic kidney disease (9.47% vs. 25.14%, p<0.01) were significantly higher in the no CCY group. The total follow-up duration was significantly longer in the CCY within 2 months group than in the no CCY within 2 months group (39.68 ± 23.47 vs. 23.47 ± 20.26, p=0.047). The detailed baseline demographic data are shown in Table 1. Reflecting the culture in Taiwan, surgical intervention is the last choice for treatment. In our analysis, only 190 (52.05%) of the 365 patients underwent CCY within 60 days after previous PTGBD during index admission for acute cholecystitis. In addition, 25 patients eventually accepted CCY during follow-up, and 15 (60%) of these patients underwent laparoscopic CCY. The overall mortality rate was 19.47% in the CCY within 2 months group and 50.29% in the no CCY within 2 months group, in which the patients had higher CCI scores and older age. In terms of RBE-related mortality, 5 patients died in the no CCY within 2 months group, while no patients died in the CCY within 2 months group. Therefore, the CCY within 2 months group had a better survival probability in our analysis. RBEs The definition of RBE included ER visits and admissions due to cholelithiasis, cholecystitis, cholangitis, and biliary pancreatitis. Although the time to the event was shorter in the CCY within 2 months group (9.6 ± 15.18 months) than in the no CCY within 2 months group (11.21 ± 13.92 months), the total number of RBEs was higher in the no CCY within 2 months group. The total number of RBEs was 111 events in 59 patients in the CCY within 2 months group and 173 RBEs in 81 patients in the no CCY within 2 months group, which showed more RBEs in the no CCY within 2 months group. This situation resulted in the total medical expenses for RBEs being much higher in the no CCY within 2 months group (68561 ± 85343 NT$ vs. 120284 ± 151225 NT$). RBE-free survival To evaluate the safety and protective effects of CCY after PTGBD for acute cholecystitis, we examined the RBE-free survival, which referred to both RBEs or mortality events as end points for measurements. RBE-free survival was significantly better in the CCY within 2 months group than in the no CCY within 2 months group (60% vs. 42%, p<0.001). The results are shown in Figure 2. After we stratified the CCY within 2 months group patients by age and CCI score, the RBE-free survival became similar to that of the no CCY within 2 months group patients when patients were older than 80 years old (56% vs. 42%, p=0.421) or had a CCI score ≥ 9 (54% vs. 42%, p=0.425). Detailed information is provided in Figure 3. Medical expenses Medical expenses for the index admission, CCY, and subsequent admissions and ER visits due to RBEs and the total medical charges were calculated. We isolated the 25 patients who eventually accepted CCY at least 2 months apart from the index admission from patients without CCY within 2 months. The average medical expenses for the index admission were 89,951 NT$, 53,866 NT$, and 188,212 NT$ in the CCY within 2 months group, CCY after 2 months group, and no CCY group, respectively. The much higher medical expenses in the no CCY group indicated the complicated clinical condition and significant comorbidities in this group of patients. For the medical expenses of RBEs, the average expenses were 120,707 NT$ in the no CCY group, which was much higher than the 68,561 NT$ in the CCY within 2 months group. The average total medical costs were 243,114 NT$, 190,970 NT$, and 172,370 NT$ in the no CCY group, CCY after 2 months group, and CCY within 2 months group (p<0.01), which suggests the later CCY was performed, the higher the medical expenses were. The medical cost comparisons are shown in Table 3. Discussion: Reflecting the culture in Taiwan, surgical intervention was always the last choice for treatment. In our analysis, only 190 (52.05%) of the 365 patients underwent CCY within 60 days after previous PTGBD during the index admission for acute cholecystitis. Although previous studies showed that CCI score and the American Society of Anesthesiologists physical status classification (ASA-PS) can be used for surgical risk classification[35] in acute cholecystitis evaluation[36, 37], some reports showed similar survival benefits and lower complication rates using laparoscopic CCY compared to initial PTGBD in high risk acute cholecystitis patients[38]. No adequate risk evaluation has ever been explored in second stage CCY after PTGBD. In our study, the data were collected for patients who underwent PTGBD for high risk acute cholecystitis (from a retrospective database that included a random selection of approximately 5% of the Taiwan population), and only 4.08% of patients underwent PTGBD instead of CCY for acute cholecystitis treatment at the index admission. This observation indicates that CCY is the favored treatment method for acute cholecystitis in Taiwan and compatible with the guideline suggestion worldwide. According to other investigations into RBEs after patients accepted PTGBD without further CCY, the cumulative incidence of biliary events was approximately 30%[39]. In our analysis, the proportion of patients who experienced RBEs was 31.05% in the CCY within 2 months group and 46.29% in the no CCY within 2 months group. Our RBE rate is higher than that of other analyses because not all of our patients accepted CCY within 2 months as a series treatment algorithm; some of them underwent CCY due to RBEs in a short time period after the index admission. Another reason is the follow-up duration was significantly longer in the CCY within 2 months group than in the no CCY within 2 months group (39.68 vs. 20.26 months, p= 0.047), which led to higher RBEs in comparison. Even in this setting, the RBEs, RBE-related medical expenses, and RBE-related mortality rate were significantly lower in the CCY within 2 months group. This finding confirmed that CCY can reduce RBEs after PTGBD treatment in high risk acute cholecystitis patients. RBE-free survival Due to improvements in technology, equipment, and surgical skills, CCY, either early CCY or delayed CCY, are the standard treatment of choice in acute cholecystitis. We focused on which patients may not benefit from the current aggressive treatment methods for acute cholecystitis. A large scaled study have been shown elderly is not a problem for CCY[40], but the definition of elderly is too young for modern society in our opinion. As we further evaluated the RBE-free survival in the CCY within 2 months group using age≥65 vs. age < 65, age ≥ 75 vs. age < 75, age ≥ 80 vs. age < 80, CCI score ≥ 6 vs. CCI score < 6, CCI score ≥ 7 vs. CCI score < 7, CCI score ≥ 8 vs. CCI score < 8, and CCI score ≥ 9 vs. CCI score < 9, we found that when patients were older than 80 years or their CCI score exceeded 9, the benefits of RBE-free survival became insignificant in the CCY within 2 months group. Medical expenses The financial impact was considered, and the patients who initially underwent PTGBD without further CCY had the highest medical costs, while the patients who initially underwent PTGBD and accepted CCY within or after 2 months from the index admission had similar total medical costs. Whether patients eventually underwent CCY or not, the medical expenses due to RBEs were higher in the no CCY within 2 months group than in the CCY within 2 months group. Earlier CCY after PTGBD decreased medical expenses. There are limitations to our study. For example, comorbidities associated with retrospective database analysis-related selection bias may confound the assignment to CCY. This selection resulted in patients of younger age with less comorbidities and conceivably better performance status in the CCY within 2 months group than in the no CCY within 2 months group. This bias makes our results more reliable if the subgroup analysis showed no benefits over patients in the CCY within 2 months group than in the no CCY within 2 months group. Another limitation is that we could not determine if the patients accepted CCY within 2 months as a series treatment algorithm after PTGBD or just accepted CCY at another cholecystitis event within 2 months because of the limitations of the NHIRD. Because whether high risk acute cholecystitis patients who undergo PTGBD accept series CCY depends on personal choices, further prospective randomized studies are not a possible solution because this limitation would be present in similar studies. Future prospective multi-center studies can clarify and avoid the selection bias in different study groups. Conclusions: We confirmed CCY after PTGBD can reduce RBEs, RBE-related medical expenses, and the RBE-related mortality rate in high surgical risk patients with acute cholecystitis. In patients who underwent PTGBD, the RBE and survival benefits of CCY within 2 months became insignificant in patients older or equal than 80 years old or with a CCI score ≥ 9. Abbreviations Cholecystectomy CCY Percutaneous transhepatic gallbladder drainage PTGBD Recurrent biliary events RBEs Charlson Comorbidity Index CCI National Health Insurance Research Database NHIRD Institutional Review Board IRB International Statistical Classification of Diseases and Related Health Problems, 9th Edition ICD-9 Emergency room ER American Society of Anesthesiologists physical status classification ASA-PS Declarations - Ethical Approval and Consent to participate Our study was approved by the Institutional Review Board of Chung Shan Medical University Hospital in Taiwan. The IRB waived the informed consent for this study and IRB number is CSMUH No. CS18136. - Consent for publication Not applicable - Availability of supporting data The datasets generated and/or analyzed during the current study are not publicly available due to the raw data obtained from NHIRD and it had time limitation. They are available from the corresponding author on reasonable request. - Competing interests All authors declare no any potential financial and non-financial conflicts of interest. - Funding This work was supported by grants from Chung Shan Medical University Hospital research program ( CSH-2013-C-032) - Authors' contributions Conception and design: Chi-Chih Wang, Ming-Hseng Tseng, Ming-Chang Tsai Acquisition of data: Ming-Hseng Tseng, Sheng-Wen Wu, Tzu-Wei Yang Analysis and interpretation of data: Chi-Chih Wang, Sheng-Wen Wu, Wen-Wei Sung Drafting of the manuscript: Chi-Chih Wang, Yao-Tung Wang Critical revision of the manuscript: Hsiang-Lin Lee, Bei-Hao Shiu Statistical analysis: Wen-Wei Sung, Ming-Hseng Tseng Supervision: Ming-Hseng Tseng, Chun-Che Lin, Ming-Chang Tsai - Acknowledgements Thanks for the assistance from Hsuan-Yi Chen, Chang-Cheng Su, Shih-Ming Huang and Wei-Liang Chen for the trivial details. 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Gastroenterol Rep (Oxf) 7:205-211 Tables Table 1 Demographic data of patients underwent percutaneous transhepatic gallbladder drainage Study group CCY within 2 months N=190 No CCY within 2 months N=175 P value N; Mean SD; % N; Mean SD; % Age (SD) 68.42 13.17 72.67 13.75 0.57 Gender Male 117 61.58 96 54.86 0.20 Female 73 38.42 79 45.14 Follow up time (months) 39.68 23.47 23.47 20.26 0.047 Comorbidity CCI score (SD) 5.77 3.41 7.79 4.10 0.01 MI 7 3.68 13 7.43 0.29 CHF 20 10.53 44 25.14 <0.01 Peripheral vascular disease 12 6.32 18 10.29 0.38 CVA 38 20.00 55 31.43 0.43 Dementia 22 11.58 28 16.00 0.47 CPD 64 33.68 70 40.00 0.45 Rheumatologic disease 6 3.16 4 2.29 0.88 PUD 101 53.16 90 51.43 0.95 Mild liver disease 40 21.05 41 23.43 0.86 DM 71 37.37 85 48.57 0.10 DM with complication 19 10.00 27 15.43 0.29 Hemiplegia or paraplegia 0 0.00 6 3.43 0.04 CKD 18 9.47 44 25.14 <0.01 Malignancy (including leukemia and lymphoma) 31 16.32 38 21.71 0.42 Liver cirrhosis 6 3.16 13 7.43 0.18 Metastatic solid tumor 10 5.26 19 10.86 0.14 HIV 0 -- 0 -- N.A. SD= standard deviation, CCI score= Charlson Comorbidity Index score, MI= Myocardial infarction, CHF= congestive heart failure, CVA= Cerebrovascular accident, PUD= Peptic ulcer disease, CPD= Chronic pulmonary disease, DM= Diabetes, CKD= chronic kidney disease, HIV= human immunodeficiency virus, N.A.= not applicable Table 2 Outcomes comparisons between patients of acute cholecystitis underwent CCY within 2 months/ No CCY within 2 months after gallbladder drainage Study group CCY within 2 months N=190 No CCY within 2 months N=175 P value N SD; % N SD; % Age (SD) 68.42 13.17 72.67 13.75 0.568 Surgical method Open CCY 102 53.68 10 5.71 N.A. Laparoscopic CCY 88 46.32 15 8.57 N.A. Time to events (months) 9.60 15.18 11.21 13.92 0.246 RBE Patients 59 31.05 81 46.29 0.003 Events 111 N.A. 173 N.A. Overall mortality 37 19.47 88 50.29 <0.001 RBE related mortality 0 0.00 5 2.86 0.025 Total RBE medical expenses (NT $) 68561 85343 120284 151225 <0.001 SD= standard deviation, CCY= cholecystectomy, RBE= recurrent biliary event, NT $＝New Taiwan dollars, N.A.= not applicable Table 3 The comparisons of medical expenses between patients underwent PTGBD accept CCY within/after 2 months or without CCY Index admission CCY Recurrent biliary events Total charges Variable AVG Expenses (NT $) p value AVG Expenses (NT $) p value AVG Expenses (NT $) p value AVG Expenses (NT $) p value CCY within 2 months (N=190) 89951±103313 <0.01 94274±91883 0.73 68561±85343 <0.01 172370±172253 <0.01 CCY after 2 months (N=25) 53866±40068 <0.01 87468±91497 ref 119219±87647 <0.01 190970±112916 <0.01 No CCY (N=150) 188212±329693 ref 0.00±0.00 N.A. 120707±170679 ref 243114±362431 ref PTGBD= percutaneous transhepatic gallbladder drainage, CCY= cholecystectomy, NT $＝ New Taiwan dollars, , AVG= average, ref= reference, N.A.= not applicable Cite Share Download PDF Status: Published Journal Publication published 14 Feb, 2021 Read the published version in Frontiers in Surgery → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-16962","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":400203,"identity":"1d8a74ef-bee7-474a-a021-a268acbced9a","order_by":1,"name":"Chi-Chih Wang","email":"","orcid":"https://orcid.org/0000-0002-8222-0503","institution":"Chung Shan Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chi-Chih","middleName":"","lastName":"Wang","suffix":""},{"id":400204,"identity":"fb3a5fb6-508d-4260-b17a-f3a9d9d0917f","order_by":2,"name":"Ming-Hseng Tseng","email":"","orcid":"","institution":"Chung Shan Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ming-Hseng","middleName":"","lastName":"Tseng","suffix":""},{"id":400205,"identity":"3d8f2fd5-60ef-4926-b14e-fb42f61bd769","order_by":3,"name":"Chun-Che Lin","email":"","orcid":"","institution":"China Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chun-Che","middleName":"","lastName":"Lin","suffix":""},{"id":400206,"identity":"3d560353-b471-4b2c-8467-3168aee64181","order_by":4,"name":"Sheng-Wen Wu","email":"","orcid":"","institution":"Chung Shan Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sheng-Wen","middleName":"","lastName":"Wu","suffix":""},{"id":400207,"identity":"386637eb-d92d-4110-8d11-abf3902cb644","order_by":5,"name":"Tzu-Wei Yang","email":"","orcid":"","institution":"Chung Shan Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tzu-Wei","middleName":"","lastName":"Yang","suffix":""},{"id":400208,"identity":"352e9b92-b712-4139-9754-ce9b98cc7884","order_by":6,"name":"Wen-Wei Sung","email":"","orcid":"","institution":"Chung Shan Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wen-Wei","middleName":"","lastName":"Sung","suffix":""},{"id":400209,"identity":"8cc720cd-8f95-4387-a689-ccead7a260e4","order_by":7,"name":"Yao-Tung Wang","email":"","orcid":"","institution":"Chung Shan Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yao-Tung","middleName":"","lastName":"Wang","suffix":""},{"id":400210,"identity":"96005614-8af7-48ab-b6f4-62d890a85743","order_by":8,"name":"Hsiang-Lin Lee","email":"","orcid":"","institution":"Chung Shan Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hsiang-Lin","middleName":"","lastName":"Lee","suffix":""},{"id":400211,"identity":"9d4863fd-d449-4630-9133-ed5f7eaba76a","order_by":9,"name":"Bei-Hao Shiu","email":"","orcid":"","institution":"Chung Shan Medical University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Bei-Hao","middleName":"","lastName":"Shiu","suffix":""},{"id":400212,"identity":"dc24725d-0132-42ec-bd58-295e6ced43ff","order_by":10,"name":"Ming-Chang Tsai","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIiWNgGAWjYJCCAwwMEjxszMxAmkFChqByHogWCxk+9rYEkBYeorQAQYWNHM8ZAyQBPMCe//DDQzdqgA6TyPn86kaNBQ8D++GjG/DaIpFmcDjnGEhL7jZrEIOBJy3tBn4tDAaHcxsgWoxz2IBaJHjM8GvhP/4BqiXnmXHOP2K0MORAbeE5w/w4t40YLTdyCiB+YW8zY87tA+kl4Bf2/uObP+fU1NnLNzM//pzzrU6On/3wMbxakAGbBJgkVjkIMH8gRfUoGAWjYBSMHAAA3vU/9BmbIn4AAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-7687-2329","institution":"Chung Shan Medical University Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Ming-Chang","middleName":"","lastName":"Tsai","suffix":""}],"badges":[],"createdAt":"2020-03-09 14:29:40","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-16962/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-16962/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.3389/fsurg.2021.630916","type":"published","date":"2021-02-15T02:42:25+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":639063,"identity":"b6707eb4-8958-415a-a6ba-596e3e8869ac","added_by":"auto","created_at":"2020-03-12 16:38:29","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":4278410,"visible":true,"origin":"","legend":"Flow chart for case selection from a database of one million nationwide representatives in Taiwan\nNHIRD= National Health Insurance Research Database, PTGBD= percutaneous transhepatic gallbladder drainage, CCY= cholecystectomy","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-16962/v1/Figure 1.jpg"},{"id":639064,"identity":"a632a618-20a4-4449-a585-9f9fcfbb5e8c","added_by":"auto","created_at":"2020-03-12 16:38:30","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":997462,"visible":true,"origin":"","legend":"Recurrent biliary event survival comparison between the CCY within 2 months group and the no CCY within 2 months group\nRBE= recurrent biliary event","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-16962/v1/Figure 2.jpg"},{"id":639065,"identity":"177df18f-00fa-41e2-ac10-2a97f883946e","added_by":"auto","created_at":"2020-03-12 16:38:30","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":2545423,"visible":true,"origin":"","legend":"Recurrent biliary event survival comparison in specific groups\nPanel A CCI ≥ 9 and CCY \u003c 9 with CCY within 2 months and no CCY within 2 months\nPanel B age ≥ 80 and age \u003c 80 with CCY within 2 months and no CCY within 2 months\nRBE= recurrent biliary event, CCI= Charlson Comorbidity Index, CCY= cholecystectomy","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-16962/v1/Figure 3.jpg"},{"id":13493502,"identity":"2d1e99fd-e1d4-4c41-a34e-029cb99282c7","added_by":"auto","created_at":"2021-09-16 22:35:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":625504,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-16962/v1/875a956b-17c9-4bf4-8318-b60f9138d76c.pdf"}],"financialInterests":"","formattedTitle":"The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage","fulltext":[{"header":"Background:","content":" \u003cp\u003eCholelithiasis is one of the most popular diseases with increasing prevalence and substantial burden on healthcare resources\u003csup\u003e[1, 2]\u003c/sup\u003e. Because the abundant access to food worldwide increases the risk of obesity, the incidence rates of cholelithiasis grow accordingly\u003csup\u003e[3, 4]\u003c/sup\u003e. Cholecystitis refers to inflammation of the gallbladder, and it can be defined as acute or chronic cholecystitis by the duration of the disease. Acute acalculous cholecystitis accounts for only less than 10%[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] of all cholecystitis patients. Acute cholecystitis is a complication of gallstone disease and typically develops in patients with a history of symptomatic gallstones[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAfter the diagnosis of acute cholecystitis, evaluations of the disease severity are necessary[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] to guide clinical management, such as early cholecystectomy (CCY) or percutaneous transhepatic gallbladder drainage (PTGBD), especially in critically ill patients[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. According to the timing of CCY, CCY can be further classified as early or delayed CCY, and early CCY is a better choice than delayed CCY in terms of hospital stay and the medical expenses of treatment[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003csup\u003e,16\u003c/sup\u003e. Compared to delayed CCY, early CCY for cases within 72 hours of symptom onset was associated with lower mortality rates and complication rates in the majority of cases in previous literature[\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Some references show that delayed CCY has a higher proportion of laparoscopy[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and a lower complication rate[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Although CCY is the only definitive therapy for acute cholecystitis[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], there are patients who cannot tolerate or do not want surgical intervention despite the benefits of early or delayed CCY. Although the role of PTGBD in acute cholecystitis remains a debate[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] compared to conservative treatment, PTGBD is useful for managing high surgical risk patients and patients with severe comorbidities[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Currently, there is no strong evidence to suggest surgery timing after patients with acute cholecystitis have undergone PTGBD[\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], but CCY could decrease the likelihood of recurrent biliary events (RBEs)[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] after successful PTGBD intervention in these patients. As a result, patients with acute cholecystitis, who were successfully treated by PTGBD, should accept further early, interval, or delayed CCY to prevent future RBEs.\u003c/p\u003e \u003cp\u003eAs our recognition, acute cholecystitis patients who have high comorbidity or were extremely old may not benefit from further CCY. We used the Charlson Comorbidity Index (CCI)[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] to represent the level of comorbidities in patients in our study, which obtained from the Taiwan National Health Insurance Research Database (NHIRD). There are no current guidelines for the optimal timing for performing CCY after PTGBD, and only few real-world studies suggest the timing of CCY[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] due to surgical complications. We attempted to evaluate the benefits of CCY after patients with acute cholecystitis underwent PTGBD and whether the benefits disappear due to severe comorbidities or old age in a retrospective database cohort study.\u003c/p\u003e "},{"header":"Methods:","content":"\u003cp\u003eOur study was approved by the Institutional Review Board (IRB) of Chung Shan Medical University Hospital in Taiwan. All methods were performed in accordance with the relevant regulations and under the surveillance of the IRB of Chung Shan Medical University Hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was a population-based retrospective cohort study based on Taiwan\u0026rsquo;s NHIRD, which covers more than 99% of the entire population \u003csup\u003e[30]\u003c/sup\u003e. The NHIRD has been described in detail in previous studies[31-33].\u003c/p\u003e\n\u003cp\u003eCholelithiasis cases were selected from one million random samples from the NHIRD between 2004 and 2011 using the codes of International Statistical Classification of Diseases and Related Health Problems, 9th Edition (ICD-9) recorded by emergency room (ER) visits or admissions. Patients with acute cholecystitis were selected using ICD-9 codes documented in 2004-2010 to ensure the follow-up period is more than one year, and then, we identified patients who underwent PTGBD (procedure code 33106B) during an index admission or during an ER course 3 days before admission. Patients who had previously undergone CCY or PTGBD between the index admission and 2004 were excluded. The observation period was selected from the index admission to December 2011 or the expired date of patients. A total of 365 patients with acute cholecystitis who underwent PTGBD were selected, and 190 of these patients accepted CCY within 2 months (60 days) after the index admission. The other 175 patients with acute cholecystitis who underwent PTGBD during the index admission did not accept CCY 2 months after the index admission. Twenty-five patients in the no CCY within 2 months group eventually underwent CCY during the follow-up period. We compared age, gender, baseline CCI score, the proportion of laparoscopic and open CCY procedures, the total follow-up time, time to events, RBEs, overall mortality, RBE-related mortality, and the total medical expenses for RBEs between these two groups. RBE-related mortality was defined as mortality events due to RBEs during hospitalization or within 5 days after discharge. The design of this study is shown in Figure 1.\u003c/p\u003e\n\u003cp\u003eAn economic analysis of the costs of the index admission, CCY events, ER visits and hospitalization due to RBEs, and the total medical expenses were compared between the CCY within 2 months group and the no CCY within 2 months group for patients with acute cholecystitis who initially underwent PTGBD under Taiwan\u0026rsquo;s national health insurance system.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData processing and statistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe one million individuals who represent the nationwide population between 2004 and 2011 in Taiwan were processed using Microsoft SQL Server 2008 R2 (Microsoft Corporation, Redmond, WA, USA) with the SQL programming language. Statistical analysis was performed using OpenEpi: Open Source Epidemiologic Statistics for Public Health, version 3.01[34]. Kaplan\u0026ndash;Meier survival analyses were conducted using SPSS version 19.\u003c/p\u003e\n\u003cp\u003eThe data obtained from the study were processed using Chi-Square (\u0026chi;\u003csup\u003e2\u003c/sup\u003e) tests for categorical variables, one-way analyses of variance (ANOVA) for continuous variables, and log-rank (Mantel\u0026ndash;Cox) tests for disease-free survival curves. A two-tailed P-value of 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results:","content":"\u003cp\u003eA total 9,248 adult patients with acute cholecystitis were selected from one million samples from January 2004 to December 2011. Because the follow-up period should be at least one year, we included 377 acute cholecystitis patients who underwent PTGBD between January 2004 and December 2010. Twelve patients were excluded because of previous PTGBD before the index admission. The data for 365 acute cholecystitis patients who underwent PTGBD at the index admission were collected. A total of 190 patients with a mean age of 68.42 \u0026plusmn; 13.17 years underwent further CCY within 2 months after the index admission. The other 175 patients, with a mean age of 72.67 \u0026plusmn; 13.75 years, did not accept further CCY within 2 months after the index admission. The baseline CCI score, 5.77 \u0026plusmn; 3.41 in the CCY within 2 months group and 7.79 \u0026plusmn; 4.10 in the no CCY within 2 months group, was significantly higher in the no CCY group (p=0.01). As for the components of the CCI, the proportions of patients with congestive heart failure (10.53% vs. 25.14%, p\u0026lt;0.01), hemiplegia or paraplegia (0% vs. 3.43%, p=0.04), and chronic kidney disease (9.47% vs. 25.14%, p\u0026lt;0.01) were significantly higher in the no CCY group. The total follow-up duration was significantly longer in the CCY within 2 months group than in the no CCY within 2 months group (39.68 \u0026plusmn; 23.47 vs. 23.47 \u0026plusmn; 20.26, p=0.047). The detailed baseline demographic data are shown in Table 1.\u003c/p\u003e\n\u003cp\u003eReflecting the culture in Taiwan, surgical intervention is the last choice for treatment. In our analysis, only 190 (52.05%) of the 365 patients underwent CCY within 60 days after previous PTGBD during index admission for acute cholecystitis. In addition, 25 patients eventually accepted CCY during follow-up, and 15 (60%) of these patients underwent laparoscopic CCY. The overall mortality rate was 19.47% in the CCY within 2 months group and 50.29% in the no CCY within 2 months group, in which the patients had higher CCI scores and older age. In terms of RBE-related mortality, 5 patients died in the no CCY within 2 months group, while no patients died in the CCY within 2 months group. Therefore, the CCY within 2 months group had a better survival probability in our analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRBEs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe definition of RBE included ER visits and admissions due to cholelithiasis, cholecystitis, cholangitis, and biliary pancreatitis. Although the time to the event was shorter in the CCY within 2 months group (9.6 \u0026plusmn; 15.18 months) than in the no CCY within 2 months group (11.21 \u0026plusmn; 13.92 months), the total number of RBEs was higher in the no CCY within 2 months group. The total number of RBEs was 111 events in 59 patients in the CCY within 2 months group and 173 RBEs in 81 patients in the no CCY within 2 months group, which showed more RBEs in the no CCY within 2 months group. This situation resulted in the total medical expenses for RBEs being much higher in the no CCY within 2 months group (68561 \u0026plusmn; 85343 NT$ vs. 120284 \u0026plusmn; 151225 NT$).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRBE-free survival\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo evaluate the safety and protective effects of CCY after PTGBD for acute cholecystitis, we examined the RBE-free survival, which referred to both RBEs or mortality events as end points for measurements. RBE-free survival was significantly better in the CCY within 2 months group than in the no CCY within 2 months group (60% vs. 42%, p\u0026lt;0.001). The results are shown in Figure 2. After we stratified the CCY within 2 months group patients by age and CCI score, the RBE-free survival became similar to that of the no CCY within 2 months group patients when patients were older than 80 years old (56% vs. 42%, p=0.421) or had a CCI score \u0026ge; 9 (54% vs. 42%, p=0.425). Detailed information is provided in Figure 3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMedical expenses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMedical expenses for the index admission, CCY, and subsequent admissions and ER visits due to RBEs and the total medical charges were calculated. We isolated the 25 patients who eventually accepted CCY at least 2 months apart from the index admission from patients without CCY within 2 months.\u003c/p\u003e\n\u003cp\u003eThe average medical expenses for the index admission were 89,951 NT$, 53,866 NT$, and 188,212 NT$ in the CCY within 2 months group, CCY after 2 months group, and no CCY group, respectively. The much higher medical expenses in the no CCY group indicated the complicated clinical condition and significant comorbidities in this group of patients. For the medical expenses of RBEs, the average expenses were 120,707 NT$ in the no CCY group, which was much higher than the 68,561 NT$ in the CCY within 2 months group.\u003c/p\u003e\n\u003cp\u003eThe average total medical costs were 243,114 NT$, 190,970 NT$, and 172,370 NT$ in the no CCY group, CCY after 2 months group, and CCY within 2 months group (p\u0026lt;0.01), which suggests the later CCY was performed, the higher the medical expenses were. The medical cost comparisons are shown in Table 3.\u003c/p\u003e"},{"header":"Discussion:","content":"\u003cp\u003eReflecting the culture in Taiwan, surgical intervention was always the last choice for treatment. In our analysis, only 190 (52.05%) of the 365 patients underwent CCY within 60 days after previous PTGBD during the index admission for acute cholecystitis. Although previous studies showed that CCI score and the American Society of Anesthesiologists physical status classification (ASA-PS) can be used for surgical risk classification[35] in acute cholecystitis evaluation[36, 37], some reports showed similar survival benefits and lower complication rates using laparoscopic CCY compared to initial PTGBD in high risk acute cholecystitis patients[38]. No adequate risk evaluation has ever been explored in second stage CCY after PTGBD.\u003c/p\u003e\n\u003cp\u003eIn our study, the data were collected for patients who underwent PTGBD for high risk acute cholecystitis (from a retrospective database that included a random selection of approximately 5% of the Taiwan population), and only 4.08% of patients underwent PTGBD instead of CCY for acute cholecystitis treatment at the index admission. This observation indicates that CCY is the favored treatment method for acute cholecystitis in Taiwan and compatible with the guideline suggestion worldwide.\u003c/p\u003e\n\u003cp\u003eAccording to other investigations into RBEs after patients accepted PTGBD without further CCY, the cumulative incidence of\u0026nbsp;biliary\u0026nbsp;events\u0026nbsp;was approximately 30%[39]. In our analysis, the proportion of patients who experienced RBEs was 31.05% in the CCY within 2 months group and 46.29% in the no CCY within 2 months group. Our RBE rate is higher than that of other analyses because not all of our patients accepted CCY within 2 months as a series treatment algorithm; some of them underwent CCY due to RBEs in a short time period after the index admission. Another reason is the follow-up duration was significantly longer in the CCY within 2 months group than in the no CCY within 2 months group (39.68 vs. 20.26 months, p= 0.047), which led to higher RBEs in comparison. Even in this setting, the RBEs, RBE-related medical expenses, and RBE-related mortality rate were significantly lower in the CCY within 2 months group. This finding confirmed that CCY can reduce RBEs after PTGBD treatment in high risk acute cholecystitis patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRBE-free survival \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDue to improvements in technology, equipment, and surgical skills, CCY, either early CCY or delayed CCY, are the standard treatment of choice in acute cholecystitis. We focused on which patients may not benefit from the current aggressive treatment methods for acute cholecystitis. A large scaled study have been shown elderly is not a problem for CCY[40], but the definition of elderly is too young for modern society in our opinion. As we further evaluated the RBE-free survival in the CCY within 2 months group using age\u0026ge;65 vs. age \u0026lt; 65, age \u0026ge; 75 vs. age \u0026lt; 75, age \u0026ge; 80 vs. age \u0026lt; 80, CCI score \u0026ge; 6 vs. CCI score \u0026lt; 6, CCI score \u0026ge; 7 vs. CCI score \u0026lt; 7, CCI score \u0026ge; 8 vs. CCI score \u0026lt; 8, and CCI score \u0026ge; 9 vs. CCI score \u0026lt; 9, we found that when patients were older than 80 years or their CCI score exceeded 9, the benefits of RBE-free survival became insignificant in the CCY within 2 months group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMedical expenses \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe financial impact was considered, and the patients who initially underwent PTGBD without further CCY had the highest medical costs, while the patients who initially underwent PTGBD and accepted CCY within or after 2 months from the index admission had similar total medical costs. Whether patients eventually underwent CCY or not, the medical expenses due to RBEs were higher in the no CCY within 2 months group than in the CCY within 2 months group. Earlier CCY after PTGBD decreased medical expenses.\u003c/p\u003e\n\u003cp\u003eThere are limitations to our study. For example, comorbidities associated with retrospective database analysis-related selection bias may confound the assignment to CCY. This selection resulted in patients of younger age with less comorbidities and conceivably better performance status in the CCY within 2 months group than in the no CCY within 2 months group. This bias makes our results more reliable if the subgroup analysis showed no benefits over patients in the CCY within 2 months group than in the no CCY within 2 months group. Another limitation is that we could not determine if the patients accepted CCY within 2 months as a series treatment algorithm after PTGBD or just accepted CCY at another cholecystitis event within 2 months because of the limitations of the NHIRD. Because whether high risk acute cholecystitis patients who undergo PTGBD accept series CCY depends on personal choices, further prospective randomized studies are not a possible solution because this limitation would be present in similar studies. Future prospective multi-center studies can clarify and avoid the selection bias in different study groups.\u003c/p\u003e"},{"header":"Conclusions:","content":" \u003cp\u003eWe confirmed CCY after PTGBD can reduce RBEs, RBE-related medical expenses, and the RBE-related mortality rate in high surgical risk patients with acute cholecystitis. In patients who underwent PTGBD, the RBE and survival benefits of CCY within 2\u0026nbsp;months became insignificant in patients older or equal than 80\u0026nbsp;years old or with a CCI score\u0026thinsp;\u0026ge;\u0026thinsp;9.\u003c/p\u003e "},{"header":"Abbreviations","content":" \u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCholecystectomy\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCCY\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePercutaneous transhepatic gallbladder drainage\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePTGBD\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRecurrent biliary events\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRBEs\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCharlson Comorbidity Index\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCCI\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNational Health Insurance Research Database\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNHIRD\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eInstitutional Review Board\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIRB\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eInternational Statistical Classification of Diseases and Related Health Problems, 9th Edition\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eICD-9\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEmergency room\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eER\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAmerican Society of Anesthesiologists physical status classification\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eASA-PS\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e- Ethical Approval and Consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study was approved by the Institutional Review Board of Chung Shan Medical University Hospital in Taiwan. The IRB waived the informed consent for this study and IRB number is CSMUH No. CS18136.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Consent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Availability of supporting data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to the raw data obtained from NHIRD and it had time limitation. They are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare no any potential financial and non-financial conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by grants from Chung Shan Medical University Hospital research program ( CSH-2013-C-032)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Authors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConception and design: Chi-Chih Wang, Ming-Hseng Tseng, Ming-Chang Tsai\u003c/p\u003e\n\u003cp\u003eAcquisition of data: Ming-Hseng Tseng, Sheng-Wen Wu, Tzu-Wei Yang\u003c/p\u003e\n\u003cp\u003eAnalysis and interpretation of data: Chi-Chih Wang, Sheng-Wen Wu, Wen-Wei Sung\u003c/p\u003e\n\u003cp\u003eDrafting of the manuscript: Chi-Chih Wang, Yao-Tung Wang\u003c/p\u003e\n\u003cp\u003eCritical revision of the manuscript: Hsiang-Lin Lee, Bei-Hao Shiu\u003c/p\u003e\n\u003cp\u003eStatistical analysis: Wen-Wei Sung, Ming-Hseng Tseng\u003c/p\u003e\n\u003cp\u003eSupervision: Ming-Hseng Tseng, Chun-Che Lin, Ming-Chang Tsai\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Acknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThanks for the assistance from Hsuan-Yi Chen, Chang-Cheng Su, Shih-Ming Huang and Wei-Liang Chen for the trivial details.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePeery AF, Crockett SD, Murphy CC, et al (2019) Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology 156:254-272 e211\u003c/li\u003e\n\u003cli\u003ePeery AF, Crockett SD, Barritt AS, et al (2015) Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology 149:1731-1741 e1733\u003c/li\u003e\n\u003cli\u003eShaffer EA (2005) Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 7:132-140\u003c/li\u003e\n\u003cli\u003eShaffer EA (2006) Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol 20:981-996\u003c/li\u003e\n\u003cli\u003eShapiro MJ, Luchtefeld WB, Kurzweil S, et al (1994) Acute acalculous cholecystitis in the critically ill. Am Surg 60:335-339\u003c/li\u003e\n\u003cli\u003eHuffman JL, Schenker S (2010) Acute acalculous cholecystitis: a review. Clin Gastroenterol Hepatol 8:15-22\u003c/li\u003e\n\u003cli\u003eShabanzadeh DM (2018) Incidence of gallstone disease and complications. 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Gastroenterology 137:1641-1648 e1641-1642\u003c/li\u003e\n\u003cli\u003eWu CY, Chan FK, Wu MS, et al (2010) Histamine2-receptor antagonists are an alternative to proton pump inhibitor in patients receiving clopidogrel. Gastroenterology 139:1165-1171\u003c/li\u003e\n\u003cli\u003eWang CC, Tsai MC, Sung WW, et al (2019) Risk of cholangiocarcinoma in patients undergoing therapeutic endoscopic retrograde cholangiopancreatography or cholecystectomy: A population based study. World J Gastrointest Oncol 11:238-249\u003c/li\u003e\n\u003cli\u003eDean AG SK, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version., updated 2013/04/06, accessed 2018/01/06.\u003c/li\u003e\n\u003cli\u003eHocevar LA, Fitzgerald BM, American Society of Anesthesiologists Staging (2019) In: StatPearls, Treasure Island (FL)\u003c/li\u003e\n\u003cli\u003eIwashita Y, Ohyama T, Honda G, et al (2016) What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? 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Gastroenterol Rep (Oxf) 7:205-211\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"margin: 0in 0in 0.0001pt;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif; font-size: 10px;\"\u003eTable 1 Demographic data of patients underwent percutaneous transhepatic gallbladder drainage\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border-collapse: collapse;border: none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 108.65pt;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.173285198555956%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eStudy group\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 126.4pt;border-style: solid none none;border-top-width: 1pt;border-top-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"30.505415162454874%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eCCY within 2 months\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eN=190\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 126.45pt;border-style: solid none none;border-top-width: 1pt;border-top-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"30.505415162454874%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eNo CCY within 2 months\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eN=175\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border-style: solid none none;border-top-width: 1pt;border-top-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.815884476534295%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.63882063882064%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN; Mean\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.63882063882064%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eSD; %\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.63882063882064%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN; Mean\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.63882063882064%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eSD; %\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.444717444717444%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eAge (SD)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e68.42\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13.17\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e72.67\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13.75\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.57\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eMale\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e117\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e61.58\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e96\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e54.86\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.20\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eFemale\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e73\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e38.42\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e79\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e45.14\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eFollow up time (months)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e39.68\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e23.47\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e23.47\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;text-indent: 6pt;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e20.26\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.047\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eComorbidity\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eCCI score (SD)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e5.77\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e3.41\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e7.79\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e4.10\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eMI\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e7\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e3.68\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e7.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.29\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eCHF\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e20\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e10.53\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e44\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e25.14\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ePeripheral vascular disease\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e12\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e6.32\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e18\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e10.29\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.38\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eCVA\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e38\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e20.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e55\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e31.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eDementia\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e22\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e11.58\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e28\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e16.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.47\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eCPD\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e64\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e33.68\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e70\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e40.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.45\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eRheumatologic disease\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e6\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e3.16\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e4\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e2.29\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.88\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ePUD\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e101\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e53.16\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e90\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e51.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.95\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eMild liver disease\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e40\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e21.05\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e41\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e23.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.86\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eDM\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e71\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e37.37\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e85\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e48.57\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.10\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eDM with complication\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e19\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e10.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e27\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e15.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.29\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eHemiplegia or paraplegia\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e6\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e3.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.04\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eCKD\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e18\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e9.47\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e44\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e25.14\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eMalignancy (including leukemia and lymphoma)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e31\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e16.32\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e38\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e21.71\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.42\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eLiver cirrhosis\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e6\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e3.16\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e7.43\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.18\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eMetastatic solid tumor\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e10\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e5.26\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e19\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e10.86\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.14\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 108.65pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.268115942028984%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eHIV\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e--\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.2pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 63.25pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.217391304347826%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e--\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53.5pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"12.86231884057971%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN.A.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eSD=\u0026nbsp;\u003cspan style=\"background-color: white;\"\u003estandard deviation,\u0026nbsp;\u003c/span\u003eCCI score=\u0026nbsp;\u003cspan style=\"background-color: white;\"\u003eCharlson Comorbidity Index score, MI=\u0026nbsp;\u003c/span\u003eMyocardial infarction, CHF= congestive heart failure, CVA= Cerebrovascular accident, PUD= Peptic ulcer disease, CPD= Chronic pulmonary disease, DM= Diabetes, CKD= chronic kidney disease, HIV= human immunodeficiency virus, N.A.= not applicable\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin: 0in 0in 0.0001pt;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eTable 2 Outcomes comparisons between patients of acute cholecystitis underwent CCY within 2 months/ No CCY within 2 months after gallbladder drainage\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border-collapse: collapse;border: none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 107.75pt;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eStudy group\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 125.3pt;border-style: solid none none;border-top-width: 1pt;border-top-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"30.198915009041592%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eCCY within 2 months\n \u003cbr\u003e\n \u003cbr\u003eN=190\n \u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 125.35pt;border-style: solid none none;border-top-width: 1pt;border-top-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"30.198915009041592%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eNo CCY within 2 months\n \u003cbr\u003eN=175\n \u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: solid none none;border-top-width: 1pt;border-top-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.293398533007334%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.537897310513447%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eSD; %\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.293398533007334%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.537897310513447%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eSD; %\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"18.337408312958434%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eAge (SD)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e68.42\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13.17\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e72.67\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13.75\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.568\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eSurgical method\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eOpen CCY\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e102\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e53.68\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e10 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;text-indent: 6pt;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e5.71\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN.A.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eLaparoscopic CCY\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e88\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e46.32\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e15\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;text-indent: 6pt;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e8.57\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN.A.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eTime to events (months)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e9.60\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e15.18\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e11.21\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;text-indent: 6pt;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e13.92\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.246\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eRBE\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003ePatients\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e59\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e31.05\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e81\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e46.29\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.003\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eEvents\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e111\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;N.A.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e173\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;N.A.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eOverall mortality\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e37\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e19.47\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e88\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e50.29\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eRBE related mortality\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;text-indent: 6pt;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e5\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;2.86\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.025\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 107.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.039783001808317%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eTotal RBE medical expenses (NT $)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e68561\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e85343\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.55pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.009041591320072%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e120284\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"15.189873417721518%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e151225\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.6pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.5623869801085%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin: 0in 0in 0.0001pt;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eSD= standard deviation, CCY= cholecystectomy, RBE= recurrent biliary event, NT $＝New Taiwan dollars,\u0026nbsp;N.A.= not applicable\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin: 0in 0in 0.0001pt;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eTable 3 The comparisons of medical expenses between patients underwent PTGBD accept CCY within/after 2 months or without CCY\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border-collapse: collapse;border: none;\" width=\"936\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99.25pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 22.6pt;vertical-align: top;\" valign=\"top\" width=\"14.102564102564102%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 134.65pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 22.6pt;vertical-align: top;\" valign=\"top\" width=\"19.23076923076923%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eIndex admission\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 158pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 22.6pt;vertical-align: top;\" valign=\"top\" width=\"22.542735042735043%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eCCY\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 153.85pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 22.6pt;vertical-align: top;\" valign=\"top\" width=\"21.9017094017094%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eRecurrent biliary events\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 155.95pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 22.6pt;vertical-align: top;\" valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eTotal charges\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99.25pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"14.102564102564102%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eAVG Expenses\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;(NT $)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.5pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"6.089743589743589%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ep value\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eAVG Expenses\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e(NT $)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ep value\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eAVG Expenses\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e(NT $)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ep value\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eAVG Expenses\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp;(NT $)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 52.45pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ep value\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99.25pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"14.102564102564102%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eCCY within 2 months (N=190)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e89951±103313\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.5pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"6.089743589743589%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e94274±91883\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.73\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e68561±85343\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e172370±172253\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border: none;padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99.25pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"14.102564102564102%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eCCY after 2 months (N=25)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e53866±40068\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.5pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"6.089743589743589%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;87468±91497\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eref\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 92.15pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e119219±87647\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e190970±112916\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 15pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 99.25pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"14.102564102564102%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e\u003cstrong\u003eNo CCY (N=150)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e188212±329693\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.5pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"6.089743589743589%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eref\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e0.00±0.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.75pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eN.A.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e120707±170679\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eref\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"13.14102564102564%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003e243114±362431\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63.8pt;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;height: 19.6pt;vertical-align: top;\" valign=\"top\" width=\"9.081196581196581%\"\u003e\n \u003cp style=\"margin: 0in 0in 0.0001pt;font-size:16px;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003eref\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin: 0in 0in 0.0001pt;font-family: PMingLiU, serif;\"\u003e\u003cspan style=\"font-family: \n Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: \n 10px;\"\u003ePTGBD= percutaneous transhepatic gallbladder drainage, CCY= cholecystectomy, NT $＝\u003c/span\u003e\u003c/span\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif; font-size: 10px;\"\u003eNew Taiwan dollars, , AVG= average, ref= reference, N.A.= not applicable\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"gallbladder drainage, cholecystectomy, acute cholecystitis, recurrent biliary event","lastPublishedDoi":"10.21203/rs.3.rs-16962/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-16962/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground Cholecystectomy (CCY) is the only definitive therapy for acute cholecystitis. We conducted this study to evaluate which patients may not benefit from further CCY after percutaneous transhepatic gallbladder drainage (PTGBD) has been performed in acute cholecystitis patients.\u003c/p\u003e\u003cp\u003eMethods Acute cholecystitis patients with PTGBD treatment were selected from one million random samples from the National Health Insurance Research Database obtained between January 2004 and December 2010. Recurrent biliary events (RBEs), RBE-related medical costs, RBE-related mortality rate and an RBE-free survival curve were compared in patients who accepted CCY within 2 months and patients without CCY within 2 months after the index admission.\u003c/p\u003e\u003cp\u003eResults 365 acute cholecystitis patients underwent PTGBD at the index admission. A total of 190 patients underwent further CCY within 2 months after the index admission. The other 175 patients did not accept further CCY within 2 months after the index admission. RBE-free survival was significantly better in the CCY within 2 months group (60% vs. 42%, p\u0026lt;0.001). The RBE-free survival of the CCY within 2 months group was similar to that of the no CCY within 2 months group in patients ≥ 80 years old and patients with a Charlson Comorbidity Index (CCI) score ≥ 9.\u003c/p\u003e\u003cp\u003eConclusion We confirmed CCY after PTGBD reduced RBEs, RBE-related medical expenses, and the RBE-related mortality rate in patients with acute cholecystitis. In patients who accepted PTGBD, the RBE and survival benefits of CCY within 2 months became insignificant in patients ≥ 80 years old or with a CCI score ≥ 9.\u003c/p\u003e","manuscriptTitle":"The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-03-12 16:38:29","doi":"10.21203/rs.3.rs-16962/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"89aca635-8e3e-4890-8589-845516aac6c5","owner":[],"postedDate":"March 12th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":69366,"name":"Surgery"}],"tags":[],"updatedAt":"2021-08-20T02:42:25+00:00","versionOfRecord":{"articleIdentity":"rs-16962","link":"https://doi.org/10.3389/fsurg.2021.630916","journal":{"identity":"frontiers-in-surgery","isVorOnly":true,"title":"Frontiers in Surgery"},"publishedOn":"2021-02-15 02:42:25","publishedOnDateReadable":"February 15th, 2021"},"versionCreatedAt":"2020-03-12 16:38:29","video":"","vorDoi":"10.3389/fsurg.2021.630916","vorDoiUrl":"https://doi.org/10.3389/fsurg.2021.630916","workflowStages":[]},"version":"v1","identity":"rs-16962","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-16962","identity":"rs-16962","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}