Association of Sociodemographic Factors with Clinical Characteristics and Risk of Cholelithiasis in Patients from A Tertiary Care Hospital in Tripura

Background: Cholelithiasis (gallstone disease) represents a significant global health burden, with prevalence varying considerably across populations. While clinical factors such as obesity, dyslipidemia, and hormonal status are well-established risk factors, the independent influence of sociodemographic factors—including age, sex, socioeconomic status, education, and geographic origin—on disease presentation and risk remains complex and context-dependent. The aim is to investigate the association of sociodemographic factors with the clinical characteristics and risk of cholelithiasis in a defined patient population. Material and Methods: The present study was a hospital-based cross-sectional observational study conducted in the Department of General Surgery, Agartala Government Medical College, and Hospital over a period of one year. The study included adult patients aged 18 years or older diagnosed with cholelithiasis during the study period. Participants were recruited from the Departments of General Surgery, Gastroenterology, and Emergency Medicine, as well as from cases incidentally detected on abdominal imaging in the Radiology Department. The hospital caters to a diverse population from urban, semi-urban, and rural areas, thereby providing a representative sample for assessing the association between sociodemographic factors and disease characteristics. A total of 400 patients were included in the study. Results: The clinical profile of the study population showed that of 400 patients with cholelithiasis, 88 (22%) were asymptomatic, 192 (48%) presented with uncomplicated symptomatic cases, and 120 (30%) had complicated disease. Among the types of complications observed, acute cholecystitis was the most common, affecting 72 patients (18%), followed by choledocholithiasis in 28 patients (7%), gallstone pancreatitis in 16 patients (4%), and cholangitis in 4 patients (1%). Regarding stone characteristics, multiple stones were slightly more common, seen in 220 patients (55%), compared to single stones in 180 patients (45%). In terms of stone size, 168 patients (42%) had stones measuring 10–20 mm, followed by 152 patients (38%) with stones <10 mm, and 80 patients (20%) with stones >20 mm. Gallbladder wall thickness assessment revealed that 196 patients (49%) had a thickened wall (3–5 mm), 144 patients (36%) had normal wall thickness (<3 mm), and 60 patients (15%) had severe thickening (>5 mm). Conclusion: Sociodemographic factors, particularly sex, socioeconomic status, and geographic residence, significantly influence both the risk and clinical presentation of cholelithiasis. These findings underscore the need for targeted prevention strategies and highlight that access to care, and health literacy may modify disease outcomes. Integrating sociodemographic risk profiling into clinical practice could facilitate earlier diagnosis and risk stratification.

Keywords: Cholelithiasis, Gallstones, Sociodemographic Factors, Risk Factors, Clinical Presentation, Epidemiology, Sex Distribution, Socioeconomic Status.