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The article by Schwed et al1 compared a more recent cohort of patients with acute cholangitis (AC) at 1 of the 2 institutions (validation cohort) with a historical group of similar patients (derivation cohort). Their prior study of the derivation cohort identified 3 independent admission risk factors that predisposed to adverse outcomes in AC: white blood cell (WBC) count greater than 20 000 cells/µL (to convert to ×109 per liter, multiply by 0.001), total bilirubin level greater than 10 mg/dL (to convert to micromoles per liter, multiply by 17.104), and advanced age.2 The aim of the current study was to validate the criteria previously identified.
Murayama KM. Acute Cholangitis ManagementPrevention of Organ Failure and Death. JAMA Surg. Published online August 24, 2016. doi:10.1001/jamasurg.2016.2351