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King's College-Cambridge Prognostic Index for Patients with Primary Sclerosing Cholangitis

Purpose: To estimate survival for a person with primary sclerosing cholangitis using the prognostic index of King's College and Cambridge.

Description

Farrant et al developed a prognostic index for predicting survival in patients with primary sclerosing cholangitis. This can be used for counseling patients and aiding in the making of therapeutic decision such as liver transplantation. It was developed at King's College Hospital in London.


Parameters:

(1) hepatomegaly

(2) splenomegaly

(3) serum alkaline phosphatase in IU/L

(4) histologic stage

(5) age in years

 

Parameter

Finding

Points

hepatomegaly

absent

0

 

present

1

splenomegaly

absent

0

 

present

1

histologic stage

I

1

 

II

2

 

III

3

 

IV

4

 

prognostic index =

= (1.81 * (points for hepatomegaly)) + (0.88 * (points for splenomegaly)) + (2.66 * (LOG10(serum alkaline phosphatase in IU/L))) + (0.58 * (points for histologic stage)) + (0.04 * (age in years))

 

where:

• LOG10 is needed to get the values shown by the example in the text.

 

Interpretation:

• minimum score: around 5.3

• maximum score: around 16.0

• Most patients will have scores in the range of 10.5 to 15.

• The higher the score, the shorter the expected survival.

 

Prognostic Index

Estimated Median Survival in Years

<= 10.84

18.0

11.0

17.5

11.5

15.7

12.0

13.6

12.5

10.8

13.0

9.1

13.5

5.8

13.9

5.0

14.0

4.6

>= 14.5

3.0

estimated from Figure 2, page 1715

 

This data is somewhat linear and can be expressed as:

 

estimated median survival in years over range of 10.84 to 14.5 =

= 65.48 – (4.35 * (prognostic index))


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Specialty

Objective

ICD-10