PMID- 35402720
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220413
IS  - 2392-1099 (Print)
IS  - 2449-8238 (Electronic)
IS  - 2392-1099 (Linking)
VI  - 7
IP  - 4
DP  - 2021 Dec
TI  - Validation of TG07 and TG13/TG18 criteria for acute cholangitis and predictors of 
      in-hospital mortality in patients over 80 years old.
PG  - 396-405
LID - 10.5114/ceh.2021.110996 [doi]
AB  - AIM OF THE STUDY: This study aims to validate Tokyo guidelines (TG) 
      TG07/TG13/TG18 criteria and identify predictors of in-hospital mortality in acute 
      cholangitis (AC) patients over 80 years old. MATERIAL AND METHODS: This is a 
      retrospective audit of AC patients from January 2009 to December 2016. 
      Demographic, clinical, investigation, management, and mortality data were 
      studied. Multinomial logistic regression analysis with stepwise variable 
      selection identified predictors for in-hospital mortality. RESULTS: Three hundred 
      and eighty-eight patients were treated for AC. One hundred and sixty-two (41.8%) 
      patients were male. 230 (59.3%) patients had a history of biliary disease, 161 
      (41.5%) patients had type 2 diabetes mellitus (T2DM), and 98 (25.3%) patients had 
      ischaemic heart disease (IHD). Abdominal pain (n = 226, 58.2%), pyrexia (n = 247, 
      63.7%), and vomiting (n = 159, 41.0%) were the common presenting symptoms. 191 
      (49.2%) patients had abdominal tenderness. Positive blood cultures were recorded 
      in patients 158 (40.7%) patients. Escherichia coli was the most commonly 
      identified organism (n = 117, 30.2%). 77 (19.8%), 188 (48.5%) and 123 (31.7%) 
      patients were graded with mild, moderate, and severe AC, respectively. 30-day, 
      90-day, and in-hospital mortality were 9 (2.3%), 19 (4.9%) and 38 (9.8%), 
      respectively. On multivariate analysis, systolic blood pressure </= 100 mmHg (OR = 
      3.817, 95% CI: 1.365-10.761, p = 0.011), hypoalbuminaemia < 28 gm/l (OR = 6.052, 
      95% CI: 2.635-13.904, p < 0.001), serum creatinine >/= 176.8 (OR = 2.787, 95% CI: 
      1.146-6.778, p = 0.024) and international normalized ratio (INR) > 1.5 (OR = 
      3.247, 95% CI: 1.234-8.544, p = 0.017) were independent predictors of in-hospital 
      mortality. CONCLUSIONS: Hypotension, hypoalbuminaemia, elevated creatinine, and 
      elevated INR predict in-hospital mortality in AC patients over 80 years old.
CI  - Copyright (c) 2021 Clinical and Experimental Hepatology.
FAU - Mohan, Ramkumar
AU  - Mohan R
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Ministry of Health Holdings, Singapore.
FAU - Goh, Stefanie Wei Lynn
AU  - Goh SWL
AD  - Ministry of Health Holdings, Singapore.
FAU - Tan, GuanWei
AU  - Tan G
AD  - Ministry of Health Holdings, Singapore.
FAU - Junnarkar, Sameer P
AU  - Junnarkar SP
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Huey, CheongWei
AU  - Huey C
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Shelat, Vishal G
AU  - Shelat VG
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
AD  - Lee Kong Chian School of Medicine, Nanyang Technology University, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20211129
PL  - Poland
TA  - Clin Exp Hepatol
JT  - Clinical and experimental hepatology
JID - 101703431
PMC - PMC8977882
OTO - NOTNLM
OT  - biliary
OT  - cholangitis
OT  - sepsis
EDAT- 2022/04/12 06:00
MHDA- 2022/04/12 06:01
PMCR- 2021/12/01
CRDT- 2022/04/11 05:32
PHST- 2021/08/10 00:00 [received]
PHST- 2021/09/19 00:00 [accepted]
PHST- 2022/04/11 05:32 [entrez]
PHST- 2022/04/12 06:00 [pubmed]
PHST- 2022/04/12 06:01 [medline]
PHST- 2021/12/01 00:00 [pmc-release]
AID - 45678 [pii]
AID - 10.5114/ceh.2021.110996 [doi]
PST - ppublish
SO  - Clin Exp Hepatol. 2021 Dec;7(4):396-405. doi: 10.5114/ceh.2021.110996. Epub 2021 
      Nov 29.