Clinical characteristics, predictors, and rates of hospitalized acute cholangitis patients in the United States

BACKGROUND: Acute cholangitis (AC) is a relatively uncommon condition, with a mortality rate of 50% without prompt treatment. Our study aimed to assess the impact of demographic and social factors on morbidity, mortality and healthcare utilization of patients with AC in the United States (US). METHODS: We used data from the National Inpatient Sample (2016 and 2017). Our study population included all patients with a discharge diagnosis of AC, identified using the International Classification of Diseases, Tenth Revision (ICD-10) code K830. RESULTS: A total of 18,649 patients were hospitalized with a diagnosis of AC, with rates higher among older persons. The incidence increased notably from 142.36 cases per million in 2016 to 144.3 in 2017. The majority (53%) of patients were on Medicare. Age >60 years was associated with greater mortality compared to 0-18 years (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.21-5.43). Hispanic race (OR 1.4, 95%CI 1.15-1.76) and Black race (OR 1.3, 95%CI 1.04-1.63) had an increased mortality compared to White race. Among the factors analyzed, age >60 (OR 3.72, 95%CI 2.93-4.70) and male sex (OR 0.91, 95%CI 0.86-0.98) were found to be significantly associated with endoscopic retrograde cholangiopancreatography (ERCP) during hospitalization. The total charge for hospitalizations in 2016 was $766 million, increasing to $825 million in 2017. CONCLUSIONS: The incidence of AC in the US increased slightly year over year. In patients presenting with AC, age and race were associated with mortality while age and sex were associated with the need for ERCP.