Predictive Performance of Admission Hematological Parameters for Adverse Clinical Outcomes in Acute Cholangitis

Mustafa Çomoğlu; Emin Altıparmak; İhsan Ateş

Article Details

Predictive Performance of Admission Hematological Parameters for Adverse Clinical Outcomes in Acute Cholangitis

Authors:

Mustafa Çomoğlu | Emin Altıparmak | İhsan Ateş

Publisher:

Ankara University

Main Topics:

Gastroenterology and Hepatology

Journal:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.187-197

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001358151

pISSN:

0365-8104

Keywords:

Abstract:

 Objectives: This study aimed to evaluate the prognostic performance of hematological parameters, including red cell distribution width RDW and neutrophil-to-lymphocyte ratio NLR, in patients with acute cholangitis AC. Materials and Methods: In this prospective study, 202 patients diagnosed with AC between December 2023 and August 2024 were included. The predictive performance of admission hematological parameters for clinical outcomes, including in-hospital mortality, bacteremia, need for inotropic support, prolonged hospital stay, intensive care unit ICU admission, and prolonged ICU stay, was assessed and compared. Results: Among the 202 patients, 16 7.9 died during hospitalization. Multivariate regression analysis identified RDW as an independent risk factor for in-hospital mortality odds ratio OR: 2.25, 95 confidence interval CI: 1.483.42, p0.001. For the composite outcome, both NLR OR: 1.04, 95 CI: 1.011.07, p0.009 and RDW OR: 1.61, 95 CI: 1.262.10, p0.001 were independent risk factors. Receiver operating characteristic ROC analysis showed that RDW had the highest predictive accuracy for both in-hospital mortality AUC 95 CI: 0.826 0.7110.941 and the composite outcome AUC 95 CI: 0.761 0.6810.842 At a cut-off value of 15.6, RDW yielded a sensitivity of 75 and specificity of 88.2 for predicting in-hospital mortality. Patients with RDW 15.6 had a 21.3-fold higher risk of in-hospital mortality compared to those with lower RDW values OR: 21.3, 95 CI: 6.3-71.5. Conclusion: RDW demonstrated the strongest prognostic value among hematological parameters and may serve as a practical and reliable marker for early risk stratification in patients with AC.

 Objectives: This study aimed to evaluate the prognostic performance of hematological parameters, including red cell distribution width RDW and neutrophil-to-lymphocyte ratio NLR, in patients with acute cholangitis AC. Materials and Methods: In this prospective study, 202 patients diagnosed with AC between December 2023 and August 2024 were included. The predictive performance of admission hematological parameters for clinical outcomes, including in-hospital mortality, bacteremia, need for inotropic support, prolonged hospital stay, intensive care unit ICU admission, and prolonged ICU stay, was assessed and compared. Results: Among the 202 patients, 16 7.9 died during hospitalization. Multivariate regression analysis identified RDW as an independent risk factor for in-hospital mortality odds ratio OR: 2.25, 95 confidence interval CI: 1.483.42, p0.001. For the composite outcome, both NLR OR: 1.04, 95 CI: 1.011.07, p0.009 and RDW OR: 1.61, 95 CI: 1.262.10, p0.001 were independent risk factors. Receiver operating characteristic ROC analysis showed that RDW had the highest predictive accuracy for both in-hospital mortality AUC 95 CI: 0.826 0.7110.941 and the composite outcome AUC 95 CI: 0.761 0.6810.842 At a cut-off value of 15.6, RDW yielded a sensitivity of 75 and specificity of 88.2 for predicting in-hospital mortality. Patients with RDW 15.6 had a 21.3-fold higher risk of in-hospital mortality compared to those with lower RDW values OR: 21.3, 95 CI: 6.3-71.5. Conclusion: RDW demonstrated the strongest prognostic value among hematological parameters and may serve as a practical and reliable marker for early risk stratification in patients with AC.

 Objectives: This study aimed to evaluate the prognostic performance of hematological parameters, including red cell distribution width RDW and neutrophil-to-lymphocyte ratio NLR, in patients with acute cholangitis AC. Materials and Methods: In this prospective study, 202 patients diagnosed with AC between December 2023 and August 2024 were included. The predictive performance of admission hematological parameters for clinical outcomes, including in-hospital mortality, bacteremia, need for inotropic support, prolonged hospital stay, intensive care unit ICU admission, and prolonged ICU stay, was assessed and compared. Results: Among the 202 patients, 16 7.9 died during hospitalization. Multivariate regression analysis identified RDW as an independent risk factor for in-hospital mortality odds ratio OR: 2.25, 95 confidence interval CI: 1.483.42, p0.001. For the composite outcome, both NLR OR: 1.04, 95 CI: 1.011.07, p0.009 and RDW OR: 1.61, 95 CI: 1.262.10, p0.001 were independent risk factors. Receiver operating characteristic ROC analysis showed that RDW had the highest predictive accuracy for both in-hospital mortality AUC 95 CI: 0.826 0.7110.941 and the composite outcome AUC 95 CI: 0.761 0.6810.842 At a cut-off value of 15.6, RDW yielded a sensitivity of 75 and specificity of 88.2 for predicting in-hospital mortality. Patients with RDW 15.6 had a 21.3-fold higher risk of in-hospital mortality compared to those with lower RDW values OR: 21.3, 95 CI: 6.3-71.5. Conclusion: RDW demonstrated the strongest prognostic value among hematological parameters and may serve as a practical and reliable marker for early risk stratification in patients with AC.

 Amaç: Bu çalışma, akut kolanjit AC hastalarında eritrosit dağılım genişliği RDW ve nötrofil-lenfosit oranı NLR dahil olmak üzere hematolojik parametrelerin prognostik performansını değerlendirmeyi amaçlamıştır. Gereç ve Yöntem: Bu prospektif çalışmaya, Aralık 2023 ile Ağustos 2024 tarihleri arasında AC tanısı almış 202 hasta dâhil edildi. Başvuru anındaki hematolojik parametrelerin, hastane içi mortalite, bakteriyemi, inotrop ihtiyacı, uzamış hastane yatışı, yoğun bakım ICU yatışı ve uzamış ICU yatışı gibi klinik sonuçları öngörme gücü değerlendirildi ve karşılaştırıldı. Bulgular: Çalışmaya dâhil edilen 202 hastanın 16sı 7.9 hayatını kaybetti. Çok değişkenli regresyon analizinde RDW, hastane içi mortalite için bağımsız bir risk faktörü olarak bulundu odds ratio OR: 2.25, 95 güven aralığı GA: 1.483.42, p0.001. Kompozit sonlanım açısından hem NLR OR: 1.04, 95 GA: 1.011.07, p0.009 hem de RDW OR: 1.61, 95 GA: 1.262.10, p0.001 bağımsız risk faktörleri olarak bulundu. ROC analizinde, hematolojik parametreler arasında hastane içi mortaliteyi ve kompozit sonlanımı en iyi öngören parametrenin RDW olduğu belirlendi sırasıyla, AUC 95 GA: 0.826 0.7110.941 ve AUC 95 GA: 0.761 0.6810.842. 15.6 kesme değeri için RDWnin mortalite için duyarlılığı 75, özgüllüğü ise 88.2 olarak hesaplandı. RDW 15.6 olan hastaların, diğer hastalara kıyasla 21.3 kat daha fazla hastane içi mortalite riski taşıdığı saptandı OR: 21.3, 95 GA: 6.371.5. Sonuç: RDW, hematolojik parametreler arasında en güçlü prognostik değeri göstermiştir ve AC hastalarında erken risk sınıflandırması için pratik ve güvenilir bir belirteç olarak hizmet edebilir.

Article Details

Predictive Performance of Admission Hematological Parameters for Adverse Clinical Outcomes in Acute Cholangitis

Authors:

Mustafa Çomoğlu | Emin Altıparmak | İhsan Ateş

Publisher:

Ankara University

Main Topics:

Gastroenterology and Hepatology

Journal:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.187-197

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001358151

pISSN:

0365-8104

acute cholangitis

hematological parameters

mortalityakut kolanjit

hematolojik parametreler

mortalite

Issues

Article Details

Predictive Performance of Admission Hematological Parameters for Adverse Clinical Outcomes in Acute Cholangitis

Authors: Mustafa Çomoğlu | Emin Altıparmak | İhsan Ateş

Publisher: Ankara University

Main Topics: Gastroenterology and Hepatology

Journal: Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.187-197

Document Type: Article

Publication Date: 9/2025

Document Language: English

Document ID (Org No.): 2001358151

pISSN: 0365-8104

acute cholangitis

hematological parameters

mortalityakut kolanjit

hematolojik parametreler

mortalite

Issues

Authors:

Mustafa Çomoğlu | Emin Altıparmak | İhsan Ateş

Publisher:

Ankara University

Main Topics:

Gastroenterology and Hepatology

Journal:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.187-197

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001358151

pISSN:

0365-8104