Cargando…

Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis

INTRODUCTION: Post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis (PEC) is associated with increased morbidity and mortality in patients ERCP. The aim of the present study was to analyze the predictors of PEC and to formulate a predictive model for early diagnosis and management....

Descripción completa

Detalles Bibliográficos
Autores principales: Ismail, Hina, Yaseen, Raja Taha, Danish, Muhammad, Tasneem, Abbas Ali, Hanif, Farina, Hanif, Farrah, Jariko, Arshad, Laeeq, Syed Mudassir, Majid, Zain, Luck, Nasir Hasan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357517/
https://www.ncbi.nlm.nih.gov/pubmed/35990870
http://dx.doi.org/10.5005/jp-journals-10018-1373
_version_ 1784763726224687104
author Ismail, Hina
Yaseen, Raja Taha
Danish, Muhammad
Tasneem, Abbas Ali
Hanif, Farina
Hanif, Farrah
Jariko, Arshad
Laeeq, Syed Mudassir
Majid, Zain
Luck, Nasir Hasan
author_facet Ismail, Hina
Yaseen, Raja Taha
Danish, Muhammad
Tasneem, Abbas Ali
Hanif, Farina
Hanif, Farrah
Jariko, Arshad
Laeeq, Syed Mudassir
Majid, Zain
Luck, Nasir Hasan
author_sort Ismail, Hina
collection PubMed
description INTRODUCTION: Post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis (PEC) is associated with increased morbidity and mortality in patients ERCP. The aim of the present study was to analyze the predictors of PEC and to formulate a predictive model for early diagnosis and management. MATERIALS AND METHODS: It was a cross-sectional study that was carried out at the Sindh Institute of Urology and Transplantation from September 2019 to June 2021. All patients aged between 18 and 75 years and undergoing ERCP due to obstructive jaundice were included. Patients with altered biliary anatomy, history of hepatobiliary surgery, and concurrent sepsis were excluded. Endoscopic retrograde cholangiopancreatography intervention was performed by an expert gastroenterologist. Laboratory parameters (total leukocyte count, total bilirubin, alanine transaminase) and patient temperature were checked on admission, at 12 hours, 24 hours, and 36 hours after ERCP to document PEC. RESULTS: A total of 349 patients were included in the study. Among them, 176 (50.4%) patients were males. Common bile duct (CBD) stricture was the most common indication of ERCP seen in 148 (42.4%) patients followed by CBD stone and cholangiocarcinoma in 108 (30.9%) and 48 (13.8%) patients, respectively. The most common presenting complaint was jaundice noted in 300 (86%) patients followed by right hypochondrial pain in 280 (80.2%) and weight loss in 194 (55.6%) patients, respectively. Post-ERCP cholangitis developed in 251 (71.9%) patients. On univariate analysis, age >50 years, female gender, right hypochondrial pain, fever, bilirubin >5 mg/dL on admission, CBD stricture on ERCP, TLC of >10,000 cells/L at 12 hours, 24 hours, and 36 hours post-ERCP and rise in ALT >50 IU 24 and 48 hours post-ERCP were significantly associated with PEC. While on multivariate analysis, female gender, bilirubin >5 mg/dL on admission, CBD stricture on ERCP, post-ERCP fever, and rise in TLC of >10000 cells/L at 24 hours post-ERCP were independently associated with PEC. HinCh score was formulated and was found to be significantly associated with the presence of cholangitis. Area under the receiver operating characteristics (AUROC) of HinCh score was 0.74 and at cutoff of ≥4, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of HinCh were 81.67%, 59.18%, 83.67%, and 55.71%, respectively with a diagnostic accuracy of 75.36%. CONCLUSION: The performance of HinCh score in predicting PEC was accurate in 86% of the patients. However, further studies are needed to validate the score. HOW TO CITE THIS ARTICLE: Ismail H, Yaseen RT, Danish M, et al. Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis. Euroasian J Hepato-Gastroenterol 2022;12(1):19–23.
format Online
Article
Text
id pubmed-9357517
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Jaypee Brothers Medical Publishers
record_format MEDLINE/PubMed
spelling pubmed-93575172022-08-19 Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis Ismail, Hina Yaseen, Raja Taha Danish, Muhammad Tasneem, Abbas Ali Hanif, Farina Hanif, Farrah Jariko, Arshad Laeeq, Syed Mudassir Majid, Zain Luck, Nasir Hasan Euroasian J Hepatogastroenterol Original Article INTRODUCTION: Post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis (PEC) is associated with increased morbidity and mortality in patients ERCP. The aim of the present study was to analyze the predictors of PEC and to formulate a predictive model for early diagnosis and management. MATERIALS AND METHODS: It was a cross-sectional study that was carried out at the Sindh Institute of Urology and Transplantation from September 2019 to June 2021. All patients aged between 18 and 75 years and undergoing ERCP due to obstructive jaundice were included. Patients with altered biliary anatomy, history of hepatobiliary surgery, and concurrent sepsis were excluded. Endoscopic retrograde cholangiopancreatography intervention was performed by an expert gastroenterologist. Laboratory parameters (total leukocyte count, total bilirubin, alanine transaminase) and patient temperature were checked on admission, at 12 hours, 24 hours, and 36 hours after ERCP to document PEC. RESULTS: A total of 349 patients were included in the study. Among them, 176 (50.4%) patients were males. Common bile duct (CBD) stricture was the most common indication of ERCP seen in 148 (42.4%) patients followed by CBD stone and cholangiocarcinoma in 108 (30.9%) and 48 (13.8%) patients, respectively. The most common presenting complaint was jaundice noted in 300 (86%) patients followed by right hypochondrial pain in 280 (80.2%) and weight loss in 194 (55.6%) patients, respectively. Post-ERCP cholangitis developed in 251 (71.9%) patients. On univariate analysis, age >50 years, female gender, right hypochondrial pain, fever, bilirubin >5 mg/dL on admission, CBD stricture on ERCP, TLC of >10,000 cells/L at 12 hours, 24 hours, and 36 hours post-ERCP and rise in ALT >50 IU 24 and 48 hours post-ERCP were significantly associated with PEC. While on multivariate analysis, female gender, bilirubin >5 mg/dL on admission, CBD stricture on ERCP, post-ERCP fever, and rise in TLC of >10000 cells/L at 24 hours post-ERCP were independently associated with PEC. HinCh score was formulated and was found to be significantly associated with the presence of cholangitis. Area under the receiver operating characteristics (AUROC) of HinCh score was 0.74 and at cutoff of ≥4, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of HinCh were 81.67%, 59.18%, 83.67%, and 55.71%, respectively with a diagnostic accuracy of 75.36%. CONCLUSION: The performance of HinCh score in predicting PEC was accurate in 86% of the patients. However, further studies are needed to validate the score. HOW TO CITE THIS ARTICLE: Ismail H, Yaseen RT, Danish M, et al. Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis. Euroasian J Hepato-Gastroenterol 2022;12(1):19–23. Jaypee Brothers Medical Publishers 2022 /pmc/articles/PMC9357517/ /pubmed/35990870 http://dx.doi.org/10.5005/jp-journals-10018-1373 Text en Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Article
Ismail, Hina
Yaseen, Raja Taha
Danish, Muhammad
Tasneem, Abbas Ali
Hanif, Farina
Hanif, Farrah
Jariko, Arshad
Laeeq, Syed Mudassir
Majid, Zain
Luck, Nasir Hasan
Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis
title Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis
title_full Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis
title_fullStr Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis
title_full_unstemmed Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis
title_short Role of “HinCh Score” as a Non-invasive Predictor of Post-endoscopic Retrograde Cholangiopancreatography Cholangitis
title_sort role of “hinch score” as a non-invasive predictor of post-endoscopic retrograde cholangiopancreatography cholangitis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357517/
https://www.ncbi.nlm.nih.gov/pubmed/35990870
http://dx.doi.org/10.5005/jp-journals-10018-1373
work_keys_str_mv AT ismailhina roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT yaseenrajataha roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT danishmuhammad roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT tasneemabbasali roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT haniffarina roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT haniffarrah roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT jarikoarshad roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT laeeqsyedmudassir roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT majidzain roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis
AT lucknasirhasan roleofhinchscoreasanoninvasivepredictorofpostendoscopicretrogradecholangiopancreatographycholangitis