Evidence map›Paper›PMID 40008418›Full record

ArticleESC heart failure2025

Secondary sclerosing cholangitis in patients suffering cardiogenic shock.

Hugo Lanz, Clemens Scherer, Philipp Kasper, Christoph Adler, Leonhard Binzenhöfer, Sabine Hoffmann, Julia Höpler, Marie Kraft, Nils Gade, Raúl Nicolás Jamin and 16 more

Abstract readMulticenter Study
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Hugo LanzMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Clemens SchererMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Philipp KasperKlinik für Gastroenterologie und Hepatologie, Universitätsklinikum Köln, Köln, Germany.
Christoph AdlerKlinik für Kardiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Köln, Germany.
Leonhard BinzenhöferMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Sabine HoffmannInstitute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians, Universität München, Munich, Germany.
Julia HöplerInstitute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians, Universität München, Munich, Germany.
Marie KraftInstitute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians, Universität München, Munich, Germany.
Nils GadeMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Raúl Nicolás JaminMedizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany.
Ruben EvertzDepartment of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.
Daniel HoyerUniversitätsklinik und Poliklinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum Halle (Saale), Halle (Saale), Germany.
Jörn TongersUniversitätsklinik und Poliklinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum Halle (Saale), Halle (Saale), Germany.
Christian SchulzeKlinik für Innere Medizin I, Universitätsklinikum Jena, Jena, Germany.
Christian JungDivision of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Julia ClausDepartment of Internal Medicine/Cardiology, Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
Janine PössDepartment of Internal Medicine/Cardiology, Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
Lisa CrusiusKlinik für Innere Medizin und Kardiologie, Herzzentrum-Dresden an der Technischen Universität Dresden, Dresden, Germany.
Norman MangnerKlinik für Innere Medizin und Kardiologie, Herzzentrum-Dresden an der Technischen Universität Dresden, Dresden, Germany.
Christian HaglHerzchirurgische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany.
Georg NickenigMedizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany.
Sebastian ZimmerMedizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany.
Steffen MassbergMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Holger ThieleDepartment of Internal Medicine/Cardiology, Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
Franz HaertelKlinik für Innere Medizin I, Universitätsklinikum Jena, Jena, Germany.
Enzo LüsebrinkMedizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany.ORCID https://orcid.org/0000-0002-3214-5672

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsCardiogenic shock (CS) patients suffer from severe organ hypoperfusion, yet the incidence of secondary sclerosing cholangitis in critically ill patients (SSC-CIP) in CS is poorly described. Given the limited evidence and severity of this syndrome, we aimed to further investigate SSC-CIP in the context of CS. METHODS AND

results24 251 total CS patients admitted between 1 January 2010 and 31 December 2023 were retrospectively screened for the diagnosis of SSC-CIP across nine German tertiary care centers. Following identification of confirmed SSC-CIP diagnosis, baseline characteristics, laboratory values, SSC-CIP-specific imaging, diagnostics, and outcomes were obtained for analysis. 35 CS patients with a diagnosis of SSC-CIP were identified, representing a prevalence of 0.14% [95% confidence interval (CI) 0.10, 0.19]. Patients were predominantly male (77.1%) with a median age of 58 years (interquartile range [IQR] 52.5, 68.0). Acute myocardial infarction (42.9%) was the most common aetiology of CS, followed by cardiac arrhythmias (20.0%). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 77.1% of cases after a median of 33 days following CS onset [IQR 24, 65], showing typical biliary casts (60.0%), intraductal filling defects (28.6%), and bile duct obliteration (20.0%). Cast removal and stent placement was performed in nearly half of ERCP procedures (45.7%). Magnetic resonance cholangiopancreatography (MRCP) was performed in 22.9% of cases and showed intraductal dilation (11.4%), lumen narrowing (17.1%), or strictures (14.3%). Median intensive care unit and hospital length of stay was 43 days [IQR 33, 66] and 58 days [IQR 33, 88], respectively. In-hospital mortality was 57.1%. One-year (65.7%) and 3-year (71.4%) mortality remained high. Two patients underwent liver transplantation after a median of 113 days [IQR 105, 122] and were alive at 3-year follow-up.

conclusionsIn this multicentre retrospective analysis in a high-risk CS cohort, SSC-CIP was a rare yet serious complication of intensive care unit stay with high in-hospital mortality. Treatment options are limited, and liver transplantation remains the only viable long-term treatment option.

Indexed as

Cholangitis, SclerosingShock, CardiogenicAgedCholangiopancreatography, Endoscopic RetrogradeCritical IllnessFemaleFollow-Up StudiesGermanyHospital MortalityHumansIncidenceMaleMiddle AgedRetrospective StudiesCardiogenic shockHepatic dysfunctionSecondary sclerosing cholangitis

Identifiers

PMID40008418
PMCPMC12055343

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.