Risk factors of organ failure in cholangitis with bacteriobilia

查看全文 作　　者：Jae Min [1,2,3]Lee;Sang Hyub [1,2]Lee;Kwang Hyun [1,2]Chung;Jin Myung [4,5]Park;Ban Seok [1,2]Lee;Woo Hyun [6]Paik;Joo Kyung [7]Park;Ji Kon [1,2]Ryu;Yong-Tae [1,2]Kim

机构地区：[1]Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine;[2]Seoul National University Hospital;[3]Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital;[4]Department of Internal Medicine, Kangwon National University School of Medicine;[5]Kangwon National University Hospital;[6]Department of Internal Medicine, Inje University Ilsan Paik Hospital;[7]Department of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine

出　　处：《World Journal of Gastroenterology》索引2015年第21卷第24期,共8页

摘　　要：AIM: To identify the risk factors for organ failure(OF) in cholangitis with bacteriobilia.METHODS: 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 data.RESULTS: 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. 关键词：ACUTE CHOLANGITIS Bacteriobilia BILE culture ORGAN FAILURE

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Risk factors of organ failure in cholangitis with bacteriobilia

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