The prognosis in patients with primary biliary cirrhosis (PBC) can be estimated by the use of a prognostic index using both clinical and laboratory findings. The derivation of the index requires a liver biopsy.
Parameters:
(1) serum bilirubin in µmol/L
(2) age in years
(3) presence or absence of cirrhosis on liver biopsy
(4) serum albumin in g/L
(5) presence or absence of central cholestasis on liver biopsy
(6) therapy with azathioprine or not
Parameter |
Finding |
Points |
---|---|---|
cirrhosis |
present |
1 |
|
absent |
0 |
central cholestasis |
present |
1 |
|
absent |
0 |
therapy |
with azathioprine |
0 |
|
without azathioprine |
1 |
prognostic index =
= (2.51 * LOG10 (serum bilirubin in µmol/L)) + (0.0069 * EXP (((age in years) - 20) / 10)) + (0.88 * (cirrhosis points)) - (0.050 * (serum albumin in g/L)) + (0.68 * (central cholestasis points)) + (0.52 * (therapy points))
Interpretation:
• The higher the score, the more serious the patient's condition and the worse the prognosis.
Survival
Index |
Median Survival in years |
---|---|
< 2 |
> 9 years |
2 to 5 |
12.95 - (2.2 * (index)) years |
> 5 to 7 |
(0.25 * ((index) ^2)) - (3.75 * (index)) + 14.4 years |
> 7 |
< 6 months |
after Figure 5 page 1089
Index |
5 year survival |
---|---|
<=0 |
> 98% |
0 to 3 |
0.981 - (0.004 * (index)) - (0.03 * ((index) ^2)) |
> 3 to 4.66 |
1.78434 - (0.361446 * (index)) |
> 4.66 |
< 10% |
after Figure 4, page 1089
Purpose: To use a prognostic index to predict the prognosis in patients with primary biliary cirrhosis (PCB).
Specialty: Gastroenterology, Immunology/Rheumatology
Objective: severity, prognosis, stage
ICD-10: K74.3,