摘要Background:Acute cholangitis is an infection due to the bile duct obstruction.Despite progress in treat-ment,acute cholangitis remains potentially fatal.Early diagnosis and treatment improve the patient out-comes.The present study aimed to identify clinical and biological factors at admission associated with 30-day mortality in acute cholangitis,to build an efficient prognostic score based on these parameters and to study the performances of this new score.Methods:We enrolled all adult patients consecutively hospitalized for acute cholangitis between January 2017 and December 2021.We developed a score system named ProChol using variables significantly asso-ciated with 30-day mortality in multivariate logistic analysis and simplified this system(named sProChol)based on a simple points-based approach.Results:In total,528 patients were included,with an average age of 77±13 years,a male predominance(54.2％)and a majority of lithiasis etiology(66.5％).Mortality in 30 days was 11.9％.In multivariate logis-tic analysis,tumor etiology[adjusted odds ratio(aOR)=15.43,95％confidence interval(CI):5.90-40.40],stent obstruction(aOR=5.12,95％CI:2.02-12.99),hypoalbuminemia(aOR=3.50,95％CI:1.25-9.81),renal failure(aOR=6.51,95％CI:2.62-16.18),oxygen therapy(aOR=4.63,95％CI:1.02-20.92)and cu-rative anticoagulation(aOR=2.60,95％CI:1.23-5.52)were independently associated with the 30-day mortality while fever was a protective factor(aOR=0.37,95％CI:0.16-0.84).ProChol score using these 7 parameters and sProChol using the 3 robust factors(etiology,renal failure and anticoagulation)presented respectively an area under receiver operating characteristic(ROC)curves(AUC)of 0.81 and 0.77,higher than Tokyo(AUC=0.72)and Gravito-Soares et al.score(AUC=0.71).Patients with sProChol ≥ 4 had a significantly higher risk of transfer to intensive care unit(13.3％vs.5.1％;P＜0.001)and longer length of stay(P=0.0006).Conclusions:ProChol and sProChol constructed from simple clinico-biological parameters at admission,present interesting performances in predicting the 30-day mortality in acute cholangitis.