title: Risk factors of organ failure in cholangitis with bacteriobilia.
abstract: OBJECTIVE
  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 positive bile 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%.
  
  
  CONCLUSIONS
  ESBL organisms in blood cultures, pre-existing 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.
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Chung
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Jin Myung
authors.initials: JM
authors.lastname: Park
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Ban Seok
authors.initials: BS
authors.lastname: Lee
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Paik
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Joo Kyung
authors.initials: JK
authors.lastname: Park
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Ji Kon
authors.initials: JK
authors.lastname: Ryu
authors.affiliation: Jae Min Lee, Sang Hyub Lee, Kwang Hyun Chung, Ban Seok Lee, Ji Kon Ryu, Yong-Tae Kim, Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, South Korea.
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001646:Bile / Q000382:microbiology*; D016009:Chi-Square Distribution; D002761:Cholangitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D042883:Choledocholithiasis / Q000150:complications; D004322:Drainage; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000517:prevention & control; D015999:Multivariate Analysis; D016017:Odds Ratio; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute cholangitis; Bacteriobilia; Bile culture; Organ failure