Christensen et al developed a prognostic scores for patients with primary biliary cirrhosis (PBC). One score uses clinical and laboratory data without biopsy findings. The authors are from Hvidovre University (Copenhagen), Bispebjerg University Hospital, Rigshospitalet, King's College Hospital and Queen Elizabeth Hospital (Birmingham).
Patient selection: primary biliary cirrhosis (PBC)
Parameters:
(1) serum total bilirubin in µmol/L
(2) serum albumin in g/L
(3) age in years
(4) ascites
(5) gastrointestinal bleeding (variceal bleeding)
(6) central cholestasis
(7) serum IgM in g/L
(8) cirrhosis
points for serum bilirubin =
= LOG10(serum bilirubin) - 1.53
points for serum albumin =
= (serum albumin) - 34.3
points for age =
= (age in years) - 55
points for serum IgM =
= LOG10(IgM) - 0.47
|
Parameter |
Finding |
Points |
|
ascites |
absent |
0 |
|
|
present |
1 |
|
gastrointestinal bleeding |
absent |
0 |
|
|
present |
1 |
|
central cholestasis |
absent |
0 |
|
|
present |
1 |
|
cirrhosis |
absent |
0 |
|
|
present |
1 |
PI for all cause mortality =
= (2.26 * (points for bilirubin)) - (0.070 * (points for albumin)) + (0.027 * (points for age)) + (1.18 * (points for ascites)) + (0.95 * (points for GI bleeding)) + (1.22 * (points for central cholestasis)) - (0.90 * (points for IgM)) + (0.87 * (points for cirrhosis))
PI for hepatic mortality =
= (2.79 * (points for bilirubin)) - (0.062 * (points for albumin)) + (0.026 * (points for age)) + (1.3 * (points for ascites)) + (1.1 * (points for GI bleeding)) + (1.29 * (points for central cholestasis)) - (0.85 * (points for IgM)) + (0.88 * (points for cirrhosis))
probability of surviving X years based on all cause mortality =
= EXP(-0.016 * X * EXP(PI))
The authors also reported a pocket chart to make the calculation easier.
|
Parameter |
Finding |
Points |
|
serum bilirubin |
10 µmol/L |
-6 |
|
|
20 µmol/L |
1 |
|
|
34 µmol/L |
6 |
|
|
50 µmol/L |
10 |
|
|
70 µmol/L |
13 |
|
|
100 µmol/L |
17 |
|
|
150 µmol/L |
21 |
|
|
200 µmol/L |
23 |
|
|
300 µmol/L |
27 |
|
|
400 µmol/L |
30 |
|
|
500 µmol/L |
32 |
|
ascites |
absent |
0 |
|
|
present |
12 |
|
serum albumin |
20 g/L |
0 |
|
|
30 g/L |
-7 |
|
|
34 g/L |
-10 |
|
|
40 g/l |
-14 |
|
|
50 g/L |
-21 |
|
|
60 g/L |
-28 |
|
age |
30 years |
1 |
|
|
40 years |
4 |
|
|
50 years |
7 |
|
|
55 years |
8 |
|
|
60 years |
9 |
|
|
70 years |
12 |
|
|
80 years |
15 |
|
GI bleeding |
absent |
0 |
|
|
present |
10 |
|
central cholestasis |
absent |
0 |
|
|
present |
12 |
|
cirrhosis |
absent |
0 |
|
|
present |
9 |
|
IgM |
1 g/L |
0 |
|
|
3 g/L |
-4 |
|
|
5 g/L |
-6 |
|
|
10 g/L |
-9 |
|
|
15 g/L |
-10 |
|
|
20 g/L |
-11 |
PI for all cause mortality =
= SUM(points) / 10
Specialty: Gastroenterology, Immunology/Rheumatology
