Risk factors of organ failure in cholangitis with bacteriobilia

作     者：Jae Min Lee Sang Hyub Lee Kwang Hyun Chung Jin Myung Park Ban Seok Lee Woo Hyun Paik Joo Kyung Park Ji Kon Ryu Yong-Tae Kim 

作者机构：Departments of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul National University Hospital Department of Internal Medicine Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Internal Medicine Kangwon National University School of Medicine Kangwon National University Hospital Department of Internal Medicine Inje University Ilsan Paik Hospital Department of Gastroenterology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第24期

页      面：7506-7513页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Acute cholangitis Bacteriobilia Bile culture Organ failure 

摘      要：AIM: To identify the risk factors for organ failure(OF) in cholangitis with ***: This study included 182 patients with acute cholangitis who underwent percutaneous transhepatic biliary drainage between January 2005 and April 2013. We conducted a retrospective analysis of comprehensive clinical and laboratory ***: There were 24 cases(13.2%) of OF and five deaths(2.7%). Bile culture was positive for microbial growth in 130 out of 138(94.2%) patients. In multivariate analysis of 130 patients with positivebile cultures, significant predictive factors for OF were the presence of extended-spectrum beta-lactamase(ESBL) organisms in blood cultures, pre-existing renal dysfunction, and choledocholithiasis as an etiology, with odds ratios of 15.376, 6.319, and 3.573, respectively. We developed a scoring system with a regression coefficient of each significant variable. The OF score was calculated using the following equation:(2.7 × ESBL organisms in blood cultures) +(1.8 × pre-existing renal dysfunction) +(1.3 × choledocholithiasis). This scoring system for predicting OF was highly specific(99.1%) and had a positive predictive value of 86.2%.CONCLUSION: ESBL organisms in blood cultures, preexisting renal dysfunction, and choledocholithiasis are risk factors for OF in cholangitis with bacteriobilia. The OF scoring system may aid clinicians to identify a poor prognosis group.