Prognostic scores in primary biliary cholangitis patients with advanced disease  

作　　者：Juan Feng Jia-Min Xu Hai-Yan Fu Nan Xie Wei-Min Bao Ying-Mei Tang 

机构地区：[1]Department of Gastroenterology,The Second Affiliated Hospital of Kunming Medical University,Kunming 650101,Yunnan Province,China [2]Department of General Surgery,Yunnan Provincial First People’s Hospital,Kunming 650032,Yunnan Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第8期1774-1783,共10页世界胃肠外科杂志（英文版）（电子版）

基　　金：Medicine Leading Talents of Yunnan Province,No.L-2019013;the Yunnan Wanren Project,No.YNWR-MY-2018-028;and Clinical Research Project of the Second Affiliated Hospital of Kunming Medical University,No.2020ynlc010.

摘　　要：BACKGROUND Due to the chronic progressive disease characteristics of primary biliary cholangitis(PBC),patients with advanced PBC should not be ignored.Most prognostic score studies have focused on early stage PBC.AIM To compare the prognostic value of various risk scores in advanced PBC to help PBC patients obtain more monitoring and assessment.METHODS This study considered patients diagnosed with PBC during hospitalization between 2015 and 2021.The clinical stage was primarily middle and late,and patients usually took ursodeoxycholic acid(UDCA)after diagnosis.The discriminatory performance of the scores was assessed with concordance statistics at baseline and after 1 year of UDCA treatment.Telephone follow-up was conducted to analyze the course and disease-associated outcomes.The follow-up deadline was December 31,2021.We compared the risk score indexes between those patients who reached a composite end point of death or liver transplantation(LT)and those who remained alive at the deadline.The combined performance of prognostic scores in estimating the risk of death or LT after 1 year of UDCA treatment was assessed using Cox regression analyses.Predictive accuracy was evaluated by comparing predicted and actual survival through Kaplan-Meier analyses.RESULTS We included 397 patients who were first diagnosed with PBC during hospitalization and received UDCA treatment;most disease stages were advanced.After an average of 6.4±1.4 years of follow-up,82 patients had died,and 4 patients had undergone LT.After receiving UDCA treatment for 1 year,the score with the best discrimination performance was the Mayo,with a concordance statistic of 0.740(95%confidence interval:0.690-0.791).The albumin-bilirubin,GLOBE,and Mayo scores tended to overestimate transplant-free survival.Comparing 7 years of calibration results showed that the Mayo score was the best model.CONCLUSION The Mayo,GLOBE,UK-PBC,and ALBI scores demonstrated comparable discriminating performance for advanced stage PBC.The Mayo score showed optimal discriminato

关 键 词：Primary biliary cholangitis Prognostic value Liver transplantation CHOLANGITIS Mayo score 

分 类 号：R575.6[医药卫生—消化系统]