A revised natural history model for primary sclerosing cholangitis

W. Ray Kim, Terry M Therneau, Russell H. Wiesner, John J. Poterucha, Joanne T. Benson, Michael Malinchoc, Nicholas F La Russo, Keith D. Lindor, E. Rolland Dickson

Research output: Contribution to journalArticle

243 Citations (Scopus)

Abstract

Objective: To describe a natural history model for primary sclerosing cholangitis (PSC) that is based on routine clinical findings and test results and eliminates the need for liver biopsy. Patients and Methods: Using the Cox proportional hazards analysis, we created a survival model based on 405 patients with PSC from 5 clinical centers. Independent validation of the model was undertaken by applying it to 124 patients who were not included in the model creation. Results: Based on the multivariate analysis of 405 patients, a risk score was defined by the following formula: R = 0.03 (age [y]) + 0.54 log(e) (bilirubin [mg/dL]) + 0.54 log(e) (aspartate aminotransferase [U/L]) + 1.24 (variceal bleeding [0/1]) - 0.84 (albumin [g/dL]). The risk score was used to obtain survival estimates up to 4 years of follow-up. Application of this model to an independent group of 124 patients showed good correlation between estimated and actual survival. Conclusions: A new model to estimate patient survival in PSC includes more reproducible variables (age, bilirubin, albumin, aspartate aminotransferase, and history of variceal bleeding), has accuracy comparable to previous models, and obviates the need for a liver biopsy.

Original languageEnglish (US)
Pages (from-to)688-694
Number of pages7
JournalMayo Clinic Proceedings
Volume75
Issue number7
StatePublished - 2000

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Sclerosing Cholangitis
Natural History
Survival
Aspartate Aminotransferases
Bilirubin
Albumins
Hemorrhage
Biopsy
Liver
Multivariate Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kim, W. R., Therneau, T. M., Wiesner, R. H., Poterucha, J. J., Benson, J. T., Malinchoc, M., ... Dickson, E. R. (2000). A revised natural history model for primary sclerosing cholangitis. Mayo Clinic Proceedings, 75(7), 688-694.

A revised natural history model for primary sclerosing cholangitis. / Kim, W. Ray; Therneau, Terry M; Wiesner, Russell H.; Poterucha, John J.; Benson, Joanne T.; Malinchoc, Michael; La Russo, Nicholas F; Lindor, Keith D.; Dickson, E. Rolland.

In: Mayo Clinic Proceedings, Vol. 75, No. 7, 2000, p. 688-694.

Research output: Contribution to journalArticle

Kim, WR, Therneau, TM, Wiesner, RH, Poterucha, JJ, Benson, JT, Malinchoc, M, La Russo, NF, Lindor, KD & Dickson, ER 2000, 'A revised natural history model for primary sclerosing cholangitis', Mayo Clinic Proceedings, vol. 75, no. 7, pp. 688-694.
Kim WR, Therneau TM, Wiesner RH, Poterucha JJ, Benson JT, Malinchoc M et al. A revised natural history model for primary sclerosing cholangitis. Mayo Clinic Proceedings. 2000;75(7):688-694.
Kim, W. Ray ; Therneau, Terry M ; Wiesner, Russell H. ; Poterucha, John J. ; Benson, Joanne T. ; Malinchoc, Michael ; La Russo, Nicholas F ; Lindor, Keith D. ; Dickson, E. Rolland. / A revised natural history model for primary sclerosing cholangitis. In: Mayo Clinic Proceedings. 2000 ; Vol. 75, No. 7. pp. 688-694.
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