title: Mortality-related Factors in Patients with Malignant Obstructive Jaundice.
abstract: OBJECTIVE
  to obtain survival rate and mortality-related factors of malignant obstructive jaundice patients.
  
  
  METHODS
  all medical records of obstructive jaundice inpatient at Cipto Mangunkusumo Hospital, Jakarta from January 2010 to December 2013 were reviewed retrospectively. The following factors were analyzed in terms of mortality: age, gender, sepsis, hypoalbumin, serum bilirubin level, serum CA 19-9 level, billiary drainage, non-ampulla Vateri carcinoma, and comorbid factors.
  
  
  RESULTS
  total 181 out of 402 patients were enrolled in this study with male proportion was 58.6%, and patients aged 50 years or above was 57.5%. Multivariate analysis showed that only sepsis, unsuccessful or no prior biliary drainage and Charlson comorbid score ≥4 were independent predictors of mortality. Patients with significant prognostic factors had median survival 14 days compared with overall median survival 26 days. Score ≥2 identified as the highest prognostic score threshold with sensitivity 68%, specificity 75%, and AUC on ROC curve 0.769.
  
  
  CONCLUSIONS
  sepsis, unsuccessful or no prior bilirary drainage, and Charlson comorbid score ≥4 are factors significantly associated with shortened survival in malignant obstructive jaundice patients. Prognostic score  ≥2 was determined to classify patients into high risk mortality group. Mortality of patients with those significant prognostic factors can be predicted in 76.9%.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. juferdy.k@gmail.com.
authors.forename: Juferdy
authors.initials: J
authors.lastname: Kurniawan
authors.forename: Irsan
authors.initials: I
authors.lastname: Hasan
authors.forename: Rino Alvani
authors.initials: RA
authors.lastname: Gani
authors.forename: Marcellus
authors.initials: M
authors.lastname: Simadibrata
mesh_terms: D000368:Aged; D015897:Comorbidity; D004067:Digestive System Neoplasms / Q000150:complications* / Q000401:mortality*; D004322:Drainage; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D041781:Jaundice, Obstructive / Q000209:etiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000401:mortality; D015996:Survival Rate
keywords: malignant obstructive jaundice; mortality; prognostic factors; prognostic score; survival