ArticleInternal medicine (Tokyo, Japan)2026
Clinical Predictors of Worsening in Non-severe Acute Cholangitis.
Article in Internal medicine (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective Risk factors for progression from non-severe to severe acute cholangitis (AC) remain unclear. This study aimed to identify predictors of disease progression with a particular focus on the prognostic nutritional index (PNI). Methods We retrospectively analyzed 239 patients with Grade I or II AC who underwent endoscopic biliary drainage within 24 h of hospital presentation. The patients were classified into 2 groups: progression (n=18) and non-progression (n=221). The clinical characteristics were compared between the two groups. Results The progression group had a higher proportion of Grade II AC (83.3% vs. 47.5%, p=0.006) and received immunosuppressive therapy more frequently (27.8% vs. 5.9%, p=0.006) but had a lower PNI (36.67 vs. 39.81, p=0.003) than the non-progression group. The proportion of patients with low PNI (<38) was significantly higher in the progression group than in the non-progression group (66.6% vs. 37.6%, p=0.023). In addition, the mortality rate was significantly higher in the progression group than in the non-progression group (11.1% vs. 0.9%, p=0.029). Conclusion Progression to severe AC may be associated with Grade II AC, immunosuppressive therapy, and a low PNI. Even after early biliary drainage, patients presenting with these conditions require close clinical monitoring.
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