Risk Factors for Death of Elderly Patients with Acute Obstructive Suppurative Cholangitis.

OBJECTIVE: To identify the risk factors for death of elderly patients with acute obstructive suppurative cholangitis (AOSC).

METHODS: Three hundred and forty-eight AOSC patients > 60 years of age were retrospectively analysed in the First People's Hospital of Jining from June 2005 to June 2013. The patients were treated with endoscopic retrograde cholangiopancreatography (ERCP) immediately after AOSC was diagnosed to clear the stones and drain, and surgical procedures were then performed in the patients in whom ERCP failed. The risk factors were identified with univariate and multivariate analysis.

RESULTS: Among the 348 AOSC patients, 27 patients died after treatment. Two hundred and forty-nine patients were treated with ERCP, and 11 patients died; 99 patients were treated with ERCP plus surgery, and 16 patients died. Two hundred and thirty-two patients were treated within 24 hours after they were admitted to the hospital, and 10 patients died; 116 patients were treated beyond 24 hours, and 17 patients died. According to the results of the univariate and multivariate analysis, shock, ERCP plus surgery, advanced age, low platelet count, the presence of co-morbidities, door to treatment time > 24 hours, hypoproteinaemia, and hyperbilirubinaemia were the independent risk factors for death of elderly patients with AOSC.

CONCLUSION: The strategies of dealing with these risk factors should be researched to reduce mortality of elderly patients with AOSC.