Survival rate and factors affecting the 30-day survival of patients with acute cholangitis undergoing ERCP in Chum Phae Hospital

Abstract

Objective: To study the survival rate and factors affecting the 30-day survival of patients with acute cholangitis who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) in Chum Phae Hospital.

Materials and methods: This retrospective study was conducted at Chum Phae Hospital, Chum Phae District, Khon Kaen Province between 1 January 2019 and 31 March 2022. All patients were continuously monitored through their end-of-life status until April 30, 2022. The sample size estimated was 111 patients when the Cox regression statistic was performed to describe the relationship in terms of crude hazard ratio and adjusted hazard ratio. Data analyses were performed using Stata software version 10.1 and statistically significant was considered at p<0.05.

Results: Of 111 patients, 17 were dead within the 30-days of the treatment procedure resulting in a mortality rate of 15.32%. The univariate Cox regression analysis revealed that the significant factors affecting the 30-day survival of the patients were male gender, ASA class 4 physical status, malignant cause of cholangitis such as cholangiocarcinoma, pancreatic cancer, and periampullary cancer, and patients with severity and receiving treatment in the intensive care unit. Likewise, the multiple Cox regression showed a significant association with the malignant cause of the disease. The risk of death within 30-day was 17.31 times greater in cancer patients than in those without it (Adj. Hazard ratio 17.31, 95 % CI = 3.25-91.95; p< 0.01).

Conclusion: ERCP in cholangitis significantly reduced the 30-day mortality rate especially caused by stones in the biliary duct but the mortality rate for all causes remains high. The patients with bile duct and pancreatic cancer are at an even higher risk.