Clinical pattern and outcomes of acute cholangitis among patients at a tertiary health care facility in Kenya: a cross-sectional study.

INTRODUCTION

acute cholangitis (AC) is a life-threatening condition associated with high mortality and lethal complications, with limited data from sub-Saharan Africa. This study determines the clinical pattern and outcomes of acute cholangitis among patients admitted to Kenyatta National Hospital.

METHODS

this cross-sectional study retrieved records from the Health Records Department for patients with a discharge diagnosis of AC between 2018 and September 2025. Ethical approval was obtained from the institutional body. We performed consecutive data sampling of all available records. Demographic and clinical data were collected and analyzed using means and proportions. Associations were analyzed using Chi-square, and P-values of <0.05 were considered statistically significant.

RESULTS

among 111 acute cholangitis patients, the male-to-female ratio was 2:3, and the median age was 61 years. Median length of hospital stay was 12 days, with a 39.6% mortality rate. Malignant obstruction was the predominant etiology (67.6%), followed by benign stricture (11.7%); stent obstruction and stones each accounted for 6.3%. Malignant etiology was associated with worse outcomes (p<0.001) while ERCP drainage was protective (p<0.001). Independent predictors of in-hospital mortality were mental status changes (OR 23.034; 95% CI: 5.356-99.054) and sepsis with multiorgan dysfunction (OR 26.381; 95% CI: 4.028-172.765).

CONCLUSION

acute cholangitis in our setting is primarily due to malignant biliary obstruction and has high mortality. The strongest predictors of mortality are mental status changes and sepsis. Early diagnosis using Tokyo Guidelines 2018 (TG18) criteria, prompt biliary drainage, and critical care reduce mortality.