Acute cardiac care & resuscitation
Secondary Sclerosing Cholangitis in Patients Suffering Cardiogenic Shock
Authors' conclusion
In this multicentre retrospective analysis in a high-risk CS cohort, SSC-CIP was a rare yet serious complication of intensive care unit stay with high in-hospital mortality. Treatment options are limited, and liver transplantation remains the only viable long-term treatment option.
Study context
- Population
- Cardiogenic shock patients admitted between 1 January 2010 and 31 December 2023, screened for secondary sclerosing cholangitis in critically ill patients (SSC-CIP)total cardiogenic shock (CS) patients screened, 35 with SSC-CIP identified
- Participants
- 24,251 patients
- Outcome
- Prevalence of SSC-CIP in CS
Methodological detailsnine German tertiary care centers
- Nine German tertiary care centers
Main finding
As reported in the abstract
Prevalence
0.14% [95% confidence interval (CI) 0.10, 0.19]
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Male
- 77.1%
- Median age
- 58 years (interquartile range [IQR] 52.5, 68.0)
- Acute myocardial infarction as CS aetiology
- 42.9%
- Cardiac arrhythmias as CS aetiology
- 20.0%
Endoscopic retrograde cholangiopancreatography (ERCP)
- ERCP performed
- 77.1%
- Median time from CS onset to ERCP
- 33 days [IQR 24, 65]
- Typical biliary casts
- 60.0%
- Intraductal filling defects
- 28.6%
- Bile duct obliteration
- 20.0%
- Cast removal and stent placement
- 45.7%
Magnetic resonance cholangiopancreatography (MRCP)
- MRCP performed
- 22.9%
- Intraductal dilation
- 11.4%
- Lumen narrowing
- 17.1%
- Strictures
- 14.3%
Length of stay
- Median intensive care unit length of stay
- 43 days [IQR 33, 66]
- Median hospital length of stay
- 58 days [IQR 33, 88]
Mortality
- In-hospital mortality
- 57.1%
- One-year mortality
- 65.7%
- 3-year mortality
- 71.4%
Liver transplantation
- Patients undergoing liver transplantation
- Two
- Median time to transplantation
- 113 days [IQR 105, 122]
- Alive at 3-year follow-up
Original publication
Secondary Sclerosing Cholangitis in Patients Suffering Cardiogenic Shock. ESC Heart Fail. Published 26 February 2025. doi:10.
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