Retrospective analysis of the standardized BARD criteria for acute cholangitis in biliary atresia patients.

Autor: Madadi-Sanjani O; Department of Pediatric Surgery Hannover Medical School Hannover Germany., Calinescu AM; Swiss Pediatric Liver Center Geneva University Hospitals Geneva Switzerland.; Department of Pediatrics, Gynecology, and Obstetrics, Division of Child and Adolescent Surgery Geneva University Hospitals Geneva Switzerland.; Department of Pediatrics, Gynecology and Obstetrics University of Geneva Geneva Switzerland., Rock N; Swiss Pediatric Liver Center Geneva University Hospitals Geneva Switzerland.; Department of Pediatrics, Gynecology and Obstetrics University of Geneva Geneva Switzerland.; Department of Pediatrics, Gynecology, and Obstetrics, Gastroenterology, Hepatology and Nutrition Unit, Division of Pediatric Specialties Geneva University Hospitals Geneva Switzerland., McLin VA; Swiss Pediatric Liver Center Geneva University Hospitals Geneva Switzerland.; Department of Pediatrics, Gynecology and Obstetrics University of Geneva Geneva Switzerland.; Department of Pediatrics, Gynecology, and Obstetrics, Gastroenterology, Hepatology and Nutrition Unit, Division of Pediatric Specialties Geneva University Hospitals Geneva Switzerland., Uecker M; Department of Pediatric Surgery Hannover Medical School Hannover Germany., Kuebler JF; Department of Pediatric Surgery Hannover Medical School Hannover Germany., Petersen C; Department of Pediatric Surgery Hannover Medical School Hannover Germany., Wildhaber BE; Swiss Pediatric Liver Center Geneva University Hospitals Geneva Switzerland.; Department of Pediatrics, Gynecology, and Obstetrics, Division of Child and Adolescent Surgery Geneva University Hospitals Geneva Switzerland.; Department of Pediatrics, Gynecology and Obstetrics University of Geneva Geneva Switzerland.
Jazyk: angličtina
Zdroj: JPGN reports [JPGN Rep] 2024 Apr 12; Vol. 5 (3), pp. 309-316. Date of Electronic Publication: 2024 Apr 12 (Print Publication: 2024).
DOI: 10.1002/jpr3.12071
Abstrakt: Objectives: In 2022, the Biliary Atresia and Related Diseases (BARD) community reached a consensus for the definition of suspected and confirmed cholangitis for biliary atresia (BA) patients after hepatoportoenterostomy (HPE). This study assessed the new standardized BARD definition in a retrospective, multicenter cohort study.
Methods: We included BA cases managed between 2010 and 2020 at the Hannover Medical School and Geneva University Hospitals' Swiss Pediatric Liver Center. The standardized BARD cholangitis definition assesses four clinical items and four imaging/laboratory items to define cholangitis. The definition was retrospectively applied to all BA cases having presented, according to their physician, cholangitis within the first year after the HPE. The diagnosis defined by the standardized BARD definition was compared with the final clinical diagnosis made by physicians. The Spearman's correlation coefficient was used to test for correlation between diagnoses made by standardized and clinical appreciation.
Results: Of 185 consecutive BA patients, 59 (32%) had at least one episode of cholangitis within the first year after HPE. The correlation between the clinician's impression and the standardized BARD definition was very strong ( r  = 0.8). Confirmed cholangitis definition coincided with the clinician's impression (2.5 [±0.7]/4 clinical items, 2.6 [±0.5]/4 imaging/laboratory items). For suspected cholangitis, the threshold for diagnosis was lower within the standardized BARD definition (1.1 [±0.3]/4 clinical items, 2.2 [±0.8]/4 laboratory/imaging items).
Conclusions: This first retrospective application of the standardized BARD cholangitis definition reveals a very strong correlation with the physician's assessment before standardization. A prospective study is needed to further refine the standardized definition for cholangitis in BA patients.
Competing Interests: The authors declare no conflict of interest.
(© 2024 The Authors. JPGN Reports published by Wiley Periodicals LLC on behalf of The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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