{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:41:27Z","timestamp":1785008487246,"version":"3.55.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"St. Michael\u2019s Hospital Foundation Association Innovation Fund Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Endoscopic retrograde cholangiopancreatography (ERCP) is important in acute cholangitis (AC) management but is not available at all hospitals. The association between on-site ERCP availability and cholangitis outcomes is unknown.<\/jats:p><jats:p>We included adults diagnosed with AC at 27 hospitals in Ontario through the GEMINI network. We collected data on demographics, clinical and laboratory values, and interventions. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, intensive care unit (ICU) admission, readmission rates, and requirement for percutaneous or surgical decompression. We used multivariable regression analyses to assess the impact of on-site ERCP availability on the primary and secondary outcomes with adjustment for relevant variables.<\/jats:p><jats:p>Our cohort included 4492 patients with a median age of 75. Patients at ERCP sites had higher unadjusted rates of undergoing ERCP (55.7% at ERCP sites, 40.8% at non-ERCP sites). Patients at ERCP sites compared with non-ERCP sites did not have significantly different in-hospital mortality (adjusted odds ratio [aOR] = 2.19, 95% confidence interval [CI] = 0.86\u20135.55). Compared with non-ERCP sites, patients at ERCP sites with underlying stricturing biliary disease or pancreaticobiliary malignancy (aOR = 1.94, 95% CI = 1.14\u201313.58) or severe cholangitis (aOR = 2.17, 95% CI = 1.17\u20134.02) had higher odds of in-hospital mortality. In a post-hoc propensity score-based analysis, there was no significant difference between patients at ERCP sites compared with those at non-ERCP sites for in-hospital mortality.<\/jats:p><jats:p>Patients at ERCP sites compared with non-ERCP sites did not have significantly different mortality. Subgroups of patients with underlying stricturing biliary disease or pancreaticobiliary malignancy and severe cholangitis, who have higher mortality at ERCP sites, warrant further study.<\/jats:p>","DOI":"10.1055\/a-2494-7333","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:52:57Z","timestamp":1733187177000},"source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["On-site ERCP availability and cholangitis outcomes: Retrospective cohort study"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5090-7685","authenticated-orcid":false,"given":"Rishad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayley-Jasmin","family":"Marchena-Romero","sequence":"additional","affiliation":[{"name":"GEMINI, St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa F.","family":"Ismail","sequence":"additional","affiliation":[{"name":"GEMINI, St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surain B.","family":"Roberts","sequence":"additional","affiliation":[{"name":"GEMINI, St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikko","family":"Gimpaya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Scarborough Health Network, Scarborough, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2068-6655","authenticated-orcid":false,"given":"Michael A.","family":"Scaffidi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen's University, Kingston, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasruddin","family":"Sabrie","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-7533","authenticated-orcid":false,"given":"Kareem","family":"Khalaf","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, St Michael's Hospital, Toronto, Canada"},{"name":"Department of Gastroenterology, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Mosko","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, St Michael's Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"James","sequence":"additional","affiliation":[{"name":"Medicine, The University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nauzer","family":"Forbes","sequence":"additional","affiliation":[{"name":"Medicine, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Razak","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Michael's Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amol A.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Michael's Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir C.","family":"Grover","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Scarborough Health Network, Scarborough, 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