New simple prognostic score for primary biliary cirrhosis: Albumin‐bilirubin score

Journal of Gastroenterology and Hepatology (Australia) - Tập 30 Số 9 - Trang 1391-1396 - 2015
Anthony W.H. Chan1, Ronald Chan2, Grace Lai‐Hung Wong3,4, Vincent Wai‐Sun Wong3,4, Pui–Wah Choi1, Henry Lik‐Yuen Chan3,4, Ka‐Fai To1,4,5
1Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
2Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
3Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
4Institute of Digestive Disease, Partner State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
5Li Ka Shing Institute of Health Science, Sir Y.K. Pao Cancer Center, The Chinese University of Hong Kong, Hong Kong, China

Tóm tắt

AbstractBackground and AimSerum albumin and bilirubin are the most significant independent prognostic factors to predict hepatic events in patients with primary biliary cirrhosis (PBC). We aimed to investigate the prognostic significance of a new prognostic score, the albumin‐bilirubin (ALBI) score, among PBC patients.MethodsIn a retrospective longitudinal cohort of 61 Chinese PBC patients with follow‐up period up to 18.3 years, the prognostic performance of the ALBI in prediction of hepatic events was compared with other well‐established prognostic scores: Child–Pugh score, model of end‐stage liver disease, Mayo risk score, Yale, European, and Newcastle models.ResultsFifteen patients (24.6%) developed hepatic events during follow‐up. The c‐index (0.894) and χ2 by likelihood ratio test (36.34) of the ALBI score were highest in comparison to other models. The ALBI score was the only independent prognostic factor by multivariate analysis and its adjusted hazard ratio of developing hepatic event was 27.8 (P < 0.001). There were three prognostically different groups stratified by the ALBI score: ALBI grade 1 (≤ −2.60), grade 2 (> −2.60 to −1.39), and grade 3 (> −1.39) groups. The 2‐, 5‐, and 10‐year event‐free survivals for grade 1, grade 2, and grade 3 groups were 100.0% versus 100.0% versus 57.1%, 100.0% versus 88.5% versus 14.3%, and 100.0% versus 81.7% versus 0.0%, respectively (P < 0.001).ConclusionThe ALBI score is readily derived from a blood test without using those factors evaluated subjectively or obtained by invasive procedures. It is an independent prognostic factor for PBC patients and provides better/similar prognostic performance compared with other prognostic scores.

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Thông tin xuất bản

Journal of Gastroenterology and Hepatology (Australia)

Tập 30 Số 9

1391-1396

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