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Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis
OBJECTIVE: A positive hemoculture in acute cholangitis is serious, but a blood culture result cannot be obtained at the initial diagnosis and so cannot be used for the severity assessment and decision-making concerning urgent/early biliary drainage. Accordingly, a predictor for bacteremia at the ini...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602826/ https://www.ncbi.nlm.nih.gov/pubmed/36792196 http://dx.doi.org/10.2169/internalmedicine.0945-22 |
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author | Yamaguchi, Atsushi Wada, Kaoru Moriuchi, Riho Tao, Kanae Konishi, Hirona Tamaru, Yuzuru Kusunoki, Ryusaku Kuwai, Toshio Kouno, Hirotaka Kohno, Hiroshi |
author_facet | Yamaguchi, Atsushi Wada, Kaoru Moriuchi, Riho Tao, Kanae Konishi, Hirona Tamaru, Yuzuru Kusunoki, Ryusaku Kuwai, Toshio Kouno, Hirotaka Kohno, Hiroshi |
author_sort | Yamaguchi, Atsushi |
collection | PubMed |
description | OBJECTIVE: A positive hemoculture in acute cholangitis is serious, but a blood culture result cannot be obtained at the initial diagnosis and so cannot be used for the severity assessment and decision-making concerning urgent/early biliary drainage. Accordingly, a predictor for bacteremia at the initial diagnosis of acute cholangitis would be particularly useful. We investigated the association between neutrophil proportions in white blood cell counts (%Neutro) and bacteremic acute cholangitis. METHODS: Of 166 patients with acute cholangitis who were diagnosed with the Tokyo Guidelines 2018/2013 from April 2015 to March 2017, a total of 94 underwent blood culture assessments and were divided into those with a positive hemoculture (n=48) and a negative hemoculture (n=46) and then compared. A receiver operating characteristic curve analysis was used to evaluate the predictive ability of %Neutro and other inflammatory markers. RESULTS: The %Neutro values were significantly higher in the positive hemoculture group than in the negative hemoculture group (91.7±4.0% vs. 82.5±9.0%, p<0.0001). A cut-off %Neutro value of 89.7% was strongly associated with bacteremia (area under the curve 0.86, sensitivity 77.1%, specificity 80.4%). A %Neutro of ≥89.7% was a predictor of a positive hemoculture in univariate (p<0.0001) and multivariate analyses (p<0.001). Patients with a %Neutro ≥89.7% needed early biliary drainage more frequently than others (30/46, 65.2% vs. 18/48, 37.5%, p=0.0063). CONCLUSION: %Neutro is an independent predictor of bacteremia in patients with acute cholangitis and may contribute to decision-making concerning early biliary drainage. |
format | Online Article Text |
id | pubmed-10602826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-106028262023-10-28 Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis Yamaguchi, Atsushi Wada, Kaoru Moriuchi, Riho Tao, Kanae Konishi, Hirona Tamaru, Yuzuru Kusunoki, Ryusaku Kuwai, Toshio Kouno, Hirotaka Kohno, Hiroshi Intern Med Original Article OBJECTIVE: A positive hemoculture in acute cholangitis is serious, but a blood culture result cannot be obtained at the initial diagnosis and so cannot be used for the severity assessment and decision-making concerning urgent/early biliary drainage. Accordingly, a predictor for bacteremia at the initial diagnosis of acute cholangitis would be particularly useful. We investigated the association between neutrophil proportions in white blood cell counts (%Neutro) and bacteremic acute cholangitis. METHODS: Of 166 patients with acute cholangitis who were diagnosed with the Tokyo Guidelines 2018/2013 from April 2015 to March 2017, a total of 94 underwent blood culture assessments and were divided into those with a positive hemoculture (n=48) and a negative hemoculture (n=46) and then compared. A receiver operating characteristic curve analysis was used to evaluate the predictive ability of %Neutro and other inflammatory markers. RESULTS: The %Neutro values were significantly higher in the positive hemoculture group than in the negative hemoculture group (91.7±4.0% vs. 82.5±9.0%, p<0.0001). A cut-off %Neutro value of 89.7% was strongly associated with bacteremia (area under the curve 0.86, sensitivity 77.1%, specificity 80.4%). A %Neutro of ≥89.7% was a predictor of a positive hemoculture in univariate (p<0.0001) and multivariate analyses (p<0.001). Patients with a %Neutro ≥89.7% needed early biliary drainage more frequently than others (30/46, 65.2% vs. 18/48, 37.5%, p=0.0063). CONCLUSION: %Neutro is an independent predictor of bacteremia in patients with acute cholangitis and may contribute to decision-making concerning early biliary drainage. The Japanese Society of Internal Medicine 2023-02-15 2023-10-01 /pmc/articles/PMC10602826/ /pubmed/36792196 http://dx.doi.org/10.2169/internalmedicine.0945-22 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Yamaguchi, Atsushi Wada, Kaoru Moriuchi, Riho Tao, Kanae Konishi, Hirona Tamaru, Yuzuru Kusunoki, Ryusaku Kuwai, Toshio Kouno, Hirotaka Kohno, Hiroshi Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis |
title | Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis |
title_full | Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis |
title_fullStr | Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis |
title_full_unstemmed | Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis |
title_short | Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis |
title_sort | proportion of neutrophils in white blood cells as a useful marker for predicting bacteremic acute cholangitis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602826/ https://www.ncbi.nlm.nih.gov/pubmed/36792196 http://dx.doi.org/10.2169/internalmedicine.0945-22 |
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