Sa1426 - Weekend Versus Weekday Admission and Acute Cholangitis Outcomes in University Hospital: A Prospective Study
2018; Elsevier BV; Volume: 154; Issue: 6 Linguagem: Inglês
10.1016/s0016-5085(18)31357-x
ISSN1528-0012
AutoresVirada Anantawong, Kamin Harinwan, Sakkarin Chirapongsathorn, Krit Opuchar, Theeranun Sanpajit, Wanich Piyanirun, Chaipichit Puttapitakpong,
Tópico(s)Hemoglobinopathies and Related Disorders
Resumohours, and positive blood cultures.Bandemia was defined as $1 band, fever as $38.0.Results: 38.8% of patients met TG criteria for suspected cholangitis and 61.1% patients met TG criteria for definite cholangitis.In severity assessment, 82.1% were classified as mild, 10.4% as moderate and only 7.5% as severe.Bandemia was present 77.6%, with a mean of 16.8% bands.Only 20.9% patients had T-max greater than 38C.48.0% had abnormal WBC, with a mean WBC of 13.5.88.5% had gallstones,6.0%strictures and 7.5% had stent occlusion.40.3% had bacteremia.Discussion: Tokyo Guidelines (TG) is a standardized tool for early diagnosis of cholangitis and triage based on a constellation of clinical parameters.However, our analysis shows that TG only identified 61% as having definite cholangitis and had only 7.5% as severe despite finding frank pus at ERCP.The high number of patients with bandemia suggests that this may be an important clinical predictor of severe cholangitis and is not included in the TG.The number of patients predicted to have mild disease was unexpectedly high and adherence to these guidelines could lead to a delay in early decompression.Further studies assessing the validity the TG are warranted.
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