Age is a Risk Factor for Severity of Biliary Infection
Abstracts
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PURPOSE: Biliary infections, pigment stones, and cholangitis are more prevalent in elderly populations. It is not clear whether this is due simply to an increased prevalence of biliary bacteria, associated with advancing age, or whether advanced age itself influences the severity of illness. This study examined this question. METHODS: 267 patients with gallstone disease were prospectively studied. Three age groups were defined: <50, young (Y), 51-70, middle aged (M), and >70, elderly (E). Illness severity was classified as follows: none (no infectious manifestations), mild-moderate (fever, leukocytoses), or severe (cholangitis, bacteremia, organ failure, hypotension, abscess). Age was studied in relation to the type of gallstone, location of gallstones, bacterial presence, and illness severity. RESULTS: See Table. CONCLUSIONS: The prevalence of biliary bacteria, incidence of CBD stones, incidence of pigment stones, and the overall severity of infection increased with age. This increased illness severity in the elderly population was not simply due to increased presence of biliary bacteria since significant differences were seen among patients with biliary bacteria. Even among the sub-group of patients with bacteria-laden stones in the bile ducts, illness severity increased with age. Thus, advancing age appeared to be an independent risk factor for illness severity in patients with biliary tract infection. It not only increased the prevalence of biliary bacteria, but also the severity of the associated illness. |
