Composite Index for Outcome Burden in Acute Cholangitis (CHOLINDEX-01)

June 19, 2026 updated by: Hardik Rughwani, Asian Institute of Gastroenterology, India

Development and Internal Validation of a Multidimensional Composite Index for Outcome Burden in Acute Cholangitis: A Multicentre Retrospective Cohort Study in India

The goal of this retrospective observational study is to construct a composite outcome to measure the success of treatment in patients who are presenting with acute cholangitis (blockage and infection of bile ducts) and undergoing a drainage procedure with different modalities. The study is not intended to test any predetermined hypothesis and does not have any comparison group. The participants' data are collated from retrospective hospital records and analysed for the purpose of the study. All the procedures are in place to ensure the confidentiality of the study participants while collating, analysing and sharing study findings.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Study Aim To develop and internally validate a Composite Index that summarizes overall outcome burden in patients with acute cholangitis.

Primary Objective (Index Development)

1. To derive a Multidimensional Composite Index for Outcome Burden among patients with acute Cholangitis undergoing Biliary Drainage, that inegrates

  • Mortality (30-day and in-hospital)
  • Organ support,
  • ICU admission and ICU length of stay,
  • Complication burden and severity (AGREE and Clavien-Dindo classification as applicable),
  • Hospital length of stay,
  • 30-day reintervention
  • 30-day readmission.

Secondary Objectives

  1. To evaluate the association of the Composite Index with:

    • TG18 severity grade (I vs II vs III),
    • Baseline physiological/lab derangement (WBC, bilirubin, creatinine, lactate),
  2. To explore whether timing of biliary drainage is associated with composite index scores (exploratory-hypothesis-generating).

Study Type

Observational

Enrollment (Estimated)

514

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • India
    • Telangana
      • Hyderabad, Telangana, India, 500032
        • Recruiting
        • Asian Institute of Gastroenterology Pvt Ltd (AIG Hospitals)
        • Contact:
        • Principal Investigator:
          • Hardik Rughwani
        • Sub-Investigator:
          • Dr.Duvvur Nageshwar Reddy
        • Sub-Investigator:
          • Nitin Jagtap

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Study Population

  • Age 18 to 80 years
  • Hospital admission with definite diagnosis of acute cholangitis meeting TG18 diagnostic criteria
  • TG18 Grade I (Mild), Grade II (moderate) or Grade III (severe) at presentation/admission or prior to drainage.
  • Underwent biliary drainage attempt (ERCP/PTBD/EUS-BD) or were planned for drainage (including failures with rescue drainage).
  • First episode of index BD in case of patients undergoing multiple episodes of index BD as per operational definitions (Technical supplement 1).
  • Planned repeat BD in same admission shall be considered as continuation of the index BD and all the procedural details shall be documented and analysed.

Description

Inclusion Criteria

  • Age 18 to 80 years
  • Hospital admission with definite diagnosis of acute cholangitis meeting TG18 diagnostic criteria
  • TG18 Grade I (Mild) Grade II (moderate) or Grade III (severe) at presentation/admission or prior to drainage.
  • Underwent biliary drainage attempt (ERCP/PTBD/EUS-BD) or were planned for drainage (including failures with rescue drainage).
  • First episode of index BD in case of patients undergoing multiple episodes of index BD as per operational definitions (Technical supplement 1)
  • Planned repeat BD in same admission shall be considered as continuation of the index BD and all the procedural details shall be documented and analysed.

Exclusion Criteria

  • Pregnant women
  • Missing key outcome data (minimum required: mortality status + ICU admission status + Length of stay)
  • Non-biliary sepsis without evidence of biliary obstruction/infection on review.
  • A patients with past history of BD outside the study setting (As this is akin to second episode of Index BD)
  • Subsequent episodes of Index BD (other than the first index BD episode) among patients with more than one episode of Index BD.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients with acute cholangitis meeting TG18 diagnostic criteria underwent biliary drainage attempt
Procedure: Biliary drainage
Underwent biliary drainage attempt (ERCP/PTBD/EUS-BD) or were planned for drainage (including failures with rescue drainage)
Other Names:
  • ERCP
  • PTBD
  • EUS BD

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Multidimensional Composite Index for Outcome Burden among patients with acute Cholangitis undergoing Biliary Drainage
Time Frame: 30 days
To derive a Multidimensional Composite Index for Outcome Burden among patients with acute Cholangitis undergoing Biliary Drainage, that integrates mortality (30-day and in-hospital), organ support, ICU admission and ICU length of stay, complication burden and severity (AGREE and Clavien-Dindo classification as applicable), hospital length of stay, 30-day reintervention and 30-day readmission.
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Asian Institute of Gastroenterology, India

Collaborators

Christian Medical College, Vellore, India
Medanta, The Medicity, India
SIDS Hospital and Research Center, Surat

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • TG18/TG13 Diagnostic & Severity Criteria: Kiriyama S et al. J Hepatobiliary Pancreat Sci 2018;25:17-30. ASGE Guideline on Cholangitis Management: Buxbaum JL et al. Gastrointest Endosc 2021;94:207-221. TG18 Biliary Drainage: Mukai S et al. J Hepatobiliary Pancreat Sci 2017;24:537-549. TOKYO Criteria 2014: Isayama H et al. Dig Endosc 2015;27:259-264. TOKYO Criteria 2024: Isayama H et al. Dig Endosc 2024;36:1393-1413. Khashab MA et al. Clin Gastroenterol Hepatol 2012;10:1157-1161.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 20, 2026

Primary Completion (Estimated)

July 31, 2026

Study Completion (Estimated)

July 31, 2026

Study Registration Dates

First Submitted

June 19, 2026

First Submitted That Met QC Criteria

June 19, 2026

First Posted (Actual)

June 24, 2026

Study Record Updates

Last Update Posted (Actual)

June 24, 2026

Last Update Submitted That Met QC Criteria

June 19, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AIG/IEC-Post BH&R 79/02.2026R1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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