Risk Factors of Organ Failure in Patients with Bacteremic Cholangitis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-11-22

AUTHORS

Ban Seok Lee, Jin-Hyeok Hwang, Sang Hyub Lee, Sang Eon Jang, Eun Sun Jang, Hyun Jin Jo, Cheol Min Shin, Young Soo Park, Jin-Wook Kim, Sook-Hyang Jung, Nayoung Kim, Dong Ho Lee, Jun Kyu Lee, Soyeon Ahn

ABSTRACT

BackgroundBacteremic cholangitis carries a high mortality rate of up to 10 % in relation to organ failure (OF), including septic shock.AimThe purpose of this study was to elucidate predictive factors for OF in bacteremic cholangitis.MethodsA retrospective review of all patients diagnosed with acute cholangitis and proven bacteremia from 2003 to 2011 was performed. Comprehensive clinical and laboratory data of 211 patients were analyzed.ResultsThere were 42 cases (19.9 %) of OF and 5 deaths (2.4 %). In the multivariate logistic regression analysis, significant predictive factors for OF were successful biliary decompression, presence of extended-spectrum beta-lactamase organism (ESBL), higher total bilirubin, and higher blood urea nitrogen (BUN) level at admission with odds ratios (ORs) of 0.129, 6.793, 1.148, and 1.089, respectively. Subgroup analysis of 165 patients who underwent biliary decompression before an event (with OF: 20, without OF: 145) was performed to elucidate the risk factors for organ failure even after successful biliary drainage. Variables significantly associated with OF included ESBL and BUN (OR = 4.123 and 1.177, respectively). We developed a scoring system with regression coefficient of each significant variable. The organ failure score was calculated using the following equation: (1.4 × ESBL) + (0.2 × BUN). This scoring system for predicting OF was highly sensitive (85.0 %) and specific (83.4 %).ConclusionsBiliary decompression, ESBL, total bilirubin, and BUN are prognostic determinants in patients with bacteremic cholangitis. An organ failure scoring system may allow clinicians to identify groups with poor prognosis even after successful biliary decompression. More... »

PAGES

1091-1099

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10620-012-2478-8

DOI

http://dx.doi.org/10.1007/s10620-012-2478-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032422449

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23179153


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    "description": "BackgroundBacteremic cholangitis carries a high mortality rate of up to 10\u00a0% in relation to organ failure (OF), including septic shock.AimThe purpose of this study was to elucidate predictive factors for OF in bacteremic cholangitis.MethodsA retrospective review of all patients diagnosed with acute cholangitis and proven bacteremia from 2003 to 2011 was performed. Comprehensive clinical and laboratory data of 211 patients were analyzed.ResultsThere were 42 cases (19.9\u00a0%) of OF and 5 deaths (2.4\u00a0%). In the multivariate logistic regression analysis, significant predictive factors for OF were successful biliary decompression, presence of extended-spectrum beta-lactamase organism (ESBL), higher total bilirubin, and higher blood urea nitrogen (BUN) level at admission with odds ratios (ORs) of 0.129, 6.793, 1.148, and 1.089, respectively. Subgroup analysis of 165 patients who underwent biliary decompression before an event (with OF: 20, without OF: 145) was performed to elucidate the risk factors for organ failure even after successful biliary drainage. Variables significantly associated with OF included ESBL and BUN (OR\u00a0=\u00a04.123 and 1.177, respectively). We developed a scoring system with regression coefficient of each significant variable. The organ failure score was calculated using the following equation: (1.4\u00a0\u00d7\u00a0ESBL)\u00a0+\u00a0(0.2\u00a0\u00d7\u00a0BUN). This scoring system for predicting OF was highly sensitive (85.0\u00a0%) and specific (83.4\u00a0%).ConclusionsBiliary decompression, ESBL, total bilirubin, and BUN are prognostic determinants in patients with bacteremic cholangitis. An organ failure scoring system may allow clinicians to identify groups with poor prognosis even after successful biliary decompression.", 
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