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J Hepatobiliary Pancreat Sci. 2014 Feb;21(2):120-7. doi: 10.1002/jhbp.10. Epub 2013 Jun 20.

Severity and prognostic assessment of the endotoxin activity assay in biliary tract infection.

Author information

1
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, 239-0004, Japan. endoit@med.yokohama-cu.ac.jp.

Abstract

BACKGROUND:

Acute cholangitis and cholecystitis (AC) often progress to severe septic conditions. We evaluated the endotoxin activity assay (EAA) for assessment and prediction of the severity of AC.

METHODS:

We retrospectively reviewed 98 patients diagnosed with AC. We divided them into low (<0.4) and high (≥0.4) groups based on EAA values.

RESULTS:

Endotoxin levels showed no correlation with EAA values. Serum C-reactive protein (8.57 vs. 5.23 mg/dl, P = 0.02), procalcitonin (2.45 vs. 0.48 ng/ml, P = 0.004), and the positive culture rate of blood (50% vs. 15%, P < 0.001) were significantly higher in the high group than in the low group. Platelet counts were significantly lower in the high group than in the low group (23.9 vs. 13.5 10(4) /ml, P = 0.004). The ratio of patients with a Japanese Association for Acute Medicine disseminated intravascular coagulation score ≥4 (32% vs. 14%, P = 0.032) was significantly higher in the high group than in the low group. There was a significantly higher percentage of patients with a severe grade of AC in the high group than patients with a mild or moderate grade (32% vs. 15%, P = 0.05).

CONCLUSIONS:

Endotoxin activity assay is useful for assessment and early prediction of septic conditions due to AC.

KEYWORDS:

Cholangitis; Endotoxin; Endotoxin activity assay; Sepsis

PMID:
23798326
DOI:
10.1002/jhbp.10
[Indexed for MEDLINE]
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