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Invited Commentary
November 2016

Acute Cholangitis Management: Prevention of Organ Failure and Death

Author Affiliations
  • 1Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
JAMA Surg. 2016;151(11):1045. doi:10.1001/jamasurg.2016.2351

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.