Table 3.
Univariate and multivariate analysis of risk factors for organ failure in patients with bacteriobilia who underwent percutaneous transhepatic biliary drainage because of acute cholangitis (n = 130) n (%)
| Factor |
Univariate analysis |
Multivariate analysis |
|||
| Patients with OF (n = 22) | Patients without OF (n = 108) | P value | OR (95%CI) | P value | |
| Age ≥ 65 yr | 14 (63.6) | 57 (52.8) | 0.351 | ||
| Male/female | 11/11 | 64/44 | 0.423 | ||
| Heavy smoker1 | 0 (0.0) | 10 (9.3) | 0.211 | ||
| Heavy alcohol drinker2 | 1 (4.5) | 6 (5.6) | 1.000 | ||
| Body temperature > 38 or < 36 °C | 8 (36.4) | 33 (30.6) | 0.593 | ||
| Positive Charcot’s triad | 3 (13.6) | 13 (12.0) | 0.734 | ||
| Symptom to door time (h)1 | 96.6 ± 88.8 | 99.4 ± 175.2 | 0.106 | ||
| CCIs ≥ 4 | 10 (45.5) | 65 (60.2) | 0.202 | ||
| Pre-existing renal dysfunction | 7 (31.8) | 4 (3.7) | 0.0009 | 6.319 (1.348-29.629) | 0.0199 |
| Etiology | |||||
| Choledocholithiasis | 11 (50.0) | 25 (23.1) | 0.0109 | 3.573 (1.195-10.686) | 0.0239 |
| Benign biliary stricture | 2 (9.1) | 17 (15.7) | 0.528 | ||
| Malignant biliary obstruction | 9 (40.9) | 62 (57.4) | 0.157 | ||
| Procedure-related | 0 (0.0) | 4 (3.7) | 1.000 | ||
| Laboratory finding | |||||
| WBC > 12000 or < 4000/mm3 | 13 (59.1) | 44 (40.7) | 0.114 | ||
| Total bilirubin ≥ 5 mg/dL | 10 (45.5) | 32 (29.6) | 0.148 | ||
| ALP ≥ 250 IU/L | 14 (63.6) | 60 (55.6) | 0.485 | ||
| Albumin ≤ 2.8 g/dL | 13 (59.1) | 36 (33.3) | 0.0239 | ||
| C-reactive protein ≥ 5 mg/dL | 16 (76.2) | 74 (69.8) | 0.557 | ||
| The severity of acute cholangitis3 | |||||
| Mild | 5 (22.7) | 40 (37.0) | 0.198 | ||
| Moderate | 7 (31.8) | 41 (39.9) | 0.586 | ||
| Severe | 10 (45.5) | 27 (25.0) | 0.053 | ||
| Bile culture-Causative microorganism | |||||
| Escherichia coli | 4 (18.2) | 15 (13.9) | 0.740 | ||
| Klebsiella species | 2 (9.1) | 7 (6.5) | 0.648 | ||
| Pseudomonas species | 1 (4.5) | 10 (9.3) | 0.689 | ||
| Enterobacter species | 0 (0.0) | 2 (1.9) | 1.000 | ||
| Enterococcus species | 5 (22.7) | 9 (8.3) | 0.062 | ||
| Other organism | 2 (9.1) | 9 (8.3) | 1.000 | ||
| Multiorganism | 8 (36.4) | 56 (51.8) | 0.185 | ||
| Bile culture-ESBL | 3 (13.0) | 11 (9.6) | 0.705 | ||
| Bile culture-MRSA | 1 (4.3) | 3 (2.6) | 0.528 | ||
| Bile culture-Antibiotic resistance4 | 10 (45.5) | 52 (48.1) | 0.818 | ||
| Positive blood culture | 8 (36.4) | 36 (33.3) | 0.784 | ||
| Blood culture-Causative microorganism | |||||
| Escherichia coli | 5 (62.5) | 18 (50.0) | 0.542 | ||
| Klebsiella species | 1 (12.5) | 9 (25.0) | 1.000 | ||
| Pseudomonas species | 1 (12.5) | 5 (13.9) | 1.000 | ||
| Other organism | 0 (0.0) | 3 (8.3) | 1.000 | ||
| Multiorganism | 1 (12.5) | 1 (2.8) | 0.311 | ||
| Blood culture-ESBL | 3 (13.6) | 2 (1.9) | 0.0349 | 15.376 (1.748-135.267) | 0.0149 |
| Blood culture-Antibiotic resistance5 | 3 (13.6) | 5 (4.6) | 0.133 | ||
| Same microorganisms6 | 4 (50.0) | 16 (44.4) | 0.747 | ||
| Unsuccessful biliary decompression7 | 4 (18.2) | 8 (7.4) | 0.121 | ||
| Visit to decompression time (h)8 | 21.6 ± 13.0 | 16.7 ± 11.3 | 0.103 | ||
Heavy smoker is defined as an individual with 20 or more pack-years (1 pack year = 1 pack per day for one year) of use;
Heavy drinker is defined as an individual currently drinking alcoholic beverages in a daily amount of ≥ 80 g (male) or ≥ 40 g (female);
TG13 severity assessment criteria for acute cholangitis (at admission);
Antibiotic susceptibility of microorganisms in bile culture;
Initial antibiotic resistance of microorganisms in blood culture;
The same microbial growth in bile cultures among patients with positive blood cultures;
Reposition or additional insertion after initial PTBD insertion;
Values are presented as mean ± SD;
Statistically significant. PTBD: Percutaneous transhepatic biliary drainage; OF: Organ failure; CCIs: Charlson comorbidity index score; WBC: White blood cell; ALP: Alkaline phosphatase; ESBL: Extended-spectrum beta-lactamase; OR: Odds ratio.