Acute cholangitis in intensive care units: clinical, biological, microbiological spectrum and risk factors for mortality: a multicenter study.
| Title: | Acute cholangitis in intensive care units: clinical, biological, microbiological spectrum and risk factors for mortality: a multicenter study. |
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| Authors: | Lavillegrand JR; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.; Sorbonne Université, Paris, France.; Inserm U970, Centre de Recherche Cardiovasculaire de Paris (PARCC), Paris, France.; Mercier-Des-Rochettes E; Groupe Hospitalier Sud Île-De-France (GHSIF), Service de réanimation polyvalente, Hôpital de Melun-Sénart, 77000, Melun, France.; Baron E; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Cochin, 75014, Paris Cedex 12, France.; Pène F; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Cochin, 75014, Paris Cedex 12, France.; Contou D; Centre Hospitalier Argenteuil, Service de réanimation polyvalente et unité de surveillance continue, 95107, Argenteuil, France.; Favory R; Centre Hospitalier Universitaire Lille, Service de réanimation générale, Hôpital Salengro, 59037, Lille, France.; Préau S; Centre Hospitalier Universitaire Lille, Service de réanimation générale, Hôpital Salengro, 59037, Lille, France.; Galbois A; Service de réanimation polyvalente, Hôpital Privé Claude Galien, 91480, Quincy-sous-Sénart, France.; Molliere C; Service de réanimation polyvalente, Hôpital Privé Claude Galien, 91480, Quincy-sous-Sénart, France.; Miailhe AF; Service de médecine intensive et réanimation, Centre Hospitalier Universitaire Nantes, Hôtel-Dieu, 44000, Nantes, France.; Reignier J; Service de médecine intensive et réanimation, Centre Hospitalier Universitaire Nantes, Hôtel-Dieu, 44000, Nantes, France.; Monchi M; Groupe Hospitalier Sud Île-De-France (GHSIF), Service de réanimation polyvalente, Hôpital de Melun-Sénart, 77000, Melun, France.; Pichereau C; Centre Hospitalier Intercommunal Poissy Saint-Germain-en-Laye, Service de réanimation, Hôpital de Poissy, 78303, Poissy, France.; Thietart S; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.; Vieille T; Centre Hospitalier Régional Universitaire Besançon, Service de réanimation médicale, Hôpital Jean Minjoz, 25030, Besançon, France.; Piton G; Centre Hospitalier Régional Universitaire Besançon, Service de réanimation médicale, Hôpital Jean Minjoz, 25030, Besançon, France.; Preda G; Centre Hospitalier de Saint-Denis, Service de réanimation et soins continus, Hôpital Delafontaine, 93205, Saint-Denis, France.; Abdallah I; Centre Hospitalier Sud Seine-et-Marne, Service de réanimation, Hôpital Fontainebleau, 77300, Fontainebleau, France.; Camus M; Sorbonne Université, Paris, France.; Assistance Publique - Hôpitaux de Paris (AP-HP), Centre d'endoscopie digestive, Hôpital Saint-Antoine, Paris, France.; Maury E; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.; Sorbonne Université, Paris, France.; Guidet B; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.; Sorbonne Université, Paris, France.; Dumas G; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.; Sorbonne Université, Paris, France.; Ait-Oufella H; Assistance Publique - Hôpitaux de Paris (AP-HP), Service de médecine intensive et réanimation, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France. hafid.aitoufella@aphp.fr.; Sorbonne Université, Paris, France. hafid.aitoufella@aphp.fr.; Inserm U970, Centre de Recherche Cardiovasculaire de Paris (PARCC), Paris, France. hafid.aitoufella@aphp.fr. |
| Source: | Critical care (London, England) [Crit Care] 2021 Feb 06; Vol. 25 (1), pp. 49. Date of Electronic Publication: 2021 Feb 06. |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 9801902 Publication Model: Electronic Cited Medium: Internet ISSN: 1466-609X (Electronic) Linking ISSN: 13648535 NLM ISO Abbreviation: Crit Care Subsets: MEDLINE |
| Imprint Name(s): | Publication: London, UK : BioMed Central Ltd; Original Publication: London : Current Science Ltd, c1997- |
| MeSH Terms: | Cholangitis/*microbiology ; Cholangitis/*physiopathology ; Mortality/*trends; Cholangitis/epidemiology ; Intensive Care Units/organization & administration ; Intensive Care Units/statistics & numerical data ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Organ Dysfunction Scores ; Retrospective Studies ; Risk Factors |
| Abstract: | Background: Little is known on the outcome and risk factors for mortality of patients admitted in Intensive Care units (ICUs) for Acute cholangitis (AC).; Methods: Retrospective multicenter study included adults admitted in eleven intensive care units for a proven AC from 2005 to 2018. Risk factors for in-hospital mortality were identified using multivariate analysis.; Results: Overall, 382 patients were included, in-hospital mortality was 29%. SOFA score at admission was 8 [5-11]. Biliary obstruction was mainly related to gallstone (53%) and cancer (22%). Median total bilirubin and PCT were respectively 83 µmol/L [50-147] and 19.1 µg/L [5.3-54.8]. Sixty-three percent of patients (n = 252) had positive blood culture, mainly Gram-negative bacilli (86%) and 14% produced extended spectrum beta lactamase bacteria. At ICU admission, persisting obstruction was frequent (79%) and biliary decompression was performed using therapeutic endoscopic retrograde cholangiopancreatography (76%) and percutaneous transhepatic biliary drainage (21%). Adjusted mortality significantly decreased overtime, adjusted OR for mortality per year was 0.72 [0.54-0.96] (p = 0.02). In a multivariate analysis, factors at admission associated with in-hospital mortality were: SOFA score (OR 1.14 [95% CI 1.05-1.24] by point, p = 0.001), lactate (OR 1.21 [95% CI 1.08-1.36], by 1 mmol/L, p |
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| Contributed Indexing: | Keywords: Cholangitis; Intensive care unit; Microbiology; Outcome; Prognosis |
| Entry Date(s): | Date Created: 20210207 Date Completed: 20210825 Latest Revision: 20210825 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7866656 |
| DOI: | 10.1186/s13054-021-03480-1 |
| PMID: | 33549136 |
| Database: | MEDLINE |
Journal Article; Multicenter Study