Patient selection: bacteremic cholangitis without organ failure at the time of hospital admission
Outcome: one or more organ failures (renal, neurologic, respiratory, shock)
Key risk factors for organ failure:
(1) unsuccessful biliary decompression (successful decompression is protective with odds ratio 0.13)
(2) infection with an extended-spectrum beta-lactamase bacteria (odds ratio 6.8)
Additional risk factors for organ failure (odds ratios 1.1)
(1) higher serum total bilirbuin
(2) higher blood urea nitrogen (BUN) in mg/dL
risk score =
= (1.4 if ESBL present else 0) + (0.2 * (serum BUN in mg/dL)
Interpretation:
• minimum score: < 5
• maximum score: > 11.4 (depending on BUN)
• A score >= 4.5 was used to predict organ failure.
Performance of score at cutoff:
• The sensitivity was 85% and specificity 83% following biliary decompression.
• The sensitivity was 76% and specificity 82% for all patients.
