Abstract
Acute cholangitis (AC) is a heterogeneous disease with considerable variation in clinical presentation and high medical costs. Although the overall mortality rate is decreasing. However, the mortality in severe AC ranged from 10%-30% due to sepsis, multi-organ failure, and systemic inflammatory response syndrome. Assessing the predictors of poor outcomes, including mortality, intensive care unit (ICU) admission, and hospital stay, is vital for early and effective intervention. We assessed the predictors of mortality and ICU admission in patients with AC. We conducted a literature search in PubMed/MEDLINE, Google Scholar, and Cochrane Library for relevant articles. The keywords used were acute cholangitis, biliary cholangitis, predictors, mortality, ICU admission, and Hospital stay. In addition, we assessed the role of early vs late endoscopic retrograde cholangiopancreatography on the outcomes. Old age, end-organ failure, red cell distribution width to albumin ratio, neutrophil-to-lymphocyte ratio, platelet-lymphocyte ratio, the need for ventilator support, diabetes, electrolyte imbalance, procalcitonin-to-albumin ratio, C-reactive protein-to-albumin, Glasgow Coma Scale, and systolic hypertension are predictors of poor outcomes in AC of varying etiology, and concurrent acute pancreatitis was not associated with ICU admission.