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Table 2 “Severity assessment criteria for acute cholangitis”

From: Hepato-pancreato-biliary emergencies for the acute care surgeon: etiology, diagnosis and treatment

Grade Definition
I (mild) Acute cholangitis does not meet the criteria of “Grade II or III”, representing acute cholangitis at initial diagnosis. Notes
Patients should have early diagnosis, biliary drainage and/or treatment for etiology, and antimicrobial administration.
It is recommended that patients with acute cholangitis who do not respond to the initial medical treatment (general supportive care and antimicrobial therapy) undergo early biliary drainage or treatment for etiology.
II (moderate) Acute cholangitis associated with any two of the following conditions:
1. Abnormal white blood cell count (>12,000/mm3, < 4,000/mm3)
2. High fever (≥39°C)
3. Age (≥75 years old)
4. Hyperbilirubinemia (total bilirubin ≥ 5 mg/dL)
5. Hypoalbuminemia (< STD × 0.7)
III (severe) Acute cholangitis associated with the onset of dysfunction in at least one of any of the following organs/systems:
1. Cardiovascular dysfunction defined as hypotension requiring treatment with dopamine ≥ 5 μg/kg per min, or any dose of norepinephrine
2. Neurological dysfunction defined as decreased level of consciousness
3. Respiratory dysfunction defined as a PaO2/FiO2 ratio < 300
4. Renal dysfunction defined as oliguria, creatinine > 2.0 mg/dl
5. Hepatic dysfunction defined as PT-INR > 1.5
6. Hematological dysfunction defined as platelet count < 100,000/mm3
  1. STD lower limit of normal value.
  2. Kiriyama S, et al. [5] (with permission).