Clinical analysis and death warning identification for acute cholangitis patients / 中国医师杂志

ABSTRACT

Objective:To summarize the clinical characteristics of patients with acute cholangitis and analyze the early warning factors of death.Methods:The clinical data of patients with acute cholangitis treated in the emergency department of Beijing Friendship Hospital from May 1, 2019 to December 5, 2020 were prospectively selected. The age, gender, vital signs, basic diseases, inflammatory indexes, organ function indexes, coagulation indexes, etiology, emergency drainage and prognosis of cholangitis were analyzed to understand the clinical characteristics of acute cholangitis and find out the strongest early warning factor of 28 day death.Results:A total of 274 patients with acute cholangitis attending the emergency department were examined, which included 265 survival patients (survival group) and 9 deaths (death group). In the death group, the proportion of diabetic patients, white blood cell counts, C-reactive protein, creatinine, international standardized ratio, D-dimer, lactate dehydrogenase, fibrinogen degradation products, Sequential Organ Failure Assessment (SOFA) score were significantly higher than those in the survival group, while the albumin level and Glasgow Coma Scale (GCS) score were significantly lower than those in the survival group (all P<0.05). Multivariate logistic regression analysis showed that GCS score, creatinine level, white blood cell counts and international standardized ratio were the risk factors of death in patients with acute cholangitis (all P<0.05). Conclusions:GCS score, creatinine level, white blood cell counts and international standardized ratio are early warning factors to judge the death of patients with acute cholangitis. GCS score is the strongest predictor of death in patients with cholangitis.