Predictive value of risk factors in patients with obstructive jaundice

Abstract

Clinical and laboratory parameters that may affect post-operative mortality and morbidity were studied in 215 patients operated on for obstructive jaundice. The cause of the bile duct obstruction was benign disease in 56.7% of patients and malignant disease in 43.3%. Overall post-operative mortality and morbidity rates were 21.9% and 33.5%, respectively. Eight risk factors were shown to be associated with increased mortality: age > 70 years; malignancy; leucocytosis > 15 000 cells/μl and fever > 38.5 °C; haematocrit ≤ 30%; creatinine > 1.3 mg/dl; albumin ≤ 3 g/dl; bilirubin > 20 mg/dl; and serum alkaline phosphatase > 100 IU/I. The simultaneous presence of less than three risk factors was always associated with post-operative survival, but concomitant existence of seven or more risk factors indicated 100% mortality. Understanding the factors related to post-operative morbidity and mortality in patients with obstructive jaundice will better guide appropriate surgical or non-surgical management and lead to improved survival.