Tischendorf et al developed a prognostic score for evaluating patients with primary sclerosing cholangitis. This can help identify a patient who may benefit from more aggressive or novel therapy. The authors are from the medical school of Hannover and the Aachen University in Germany.
Parameters identified at the time of diagnosis:
(1) age in years
(2) serum albumin
(3) bilirubin elevation
(4) hepatomegaly
(5) splenomegaly
(6) dominant bile duct stenosis
(7) intrahepatic and extrahepatic duct changes (irregularities on imaging studies)
|
Parameter |
Finding |
Points |
|
serum albumin |
> 35 g/L |
0 |
|
|
<= 35 g/L (low) |
1 |
|
bilirubin elevation |
<= 3 months |
0 |
|
|
> 3 months (persistent) |
1 |
|
hepatomegaly |
absent |
0 |
|
|
present |
1 |
|
splenomegaly |
absent |
0 |
|
|
present |
1 |
|
dominant bile duct stenosis |
absent |
0 |
|
|
present |
1 |
|
changes in both intrahepatic and extrahepatic bile ducts |
absent |
0 |
|
|
present |
1 |
where:
• "Dominant bile duct" probably refers to the common bile duct.
PSC score =
= (0.028 * (age in years)) + (0.885 * (points for albumin)) + (1.065 * (points for persistent bilirubin)) + (0.872 * (points for hepatomegaly)) + (0.618 * (points for splenomegaly)) + (0.827 * (points for duct stenosis)) + (0.899 * (points for ductal changes))
Interpretation:
• minimum score: 0.028
• maximum score: over 7
|
PSC Score |
Risk Class |
Median Survival (Total Sample) |
|
< 1.54 |
1 |
16 years |
|
1.54 - 2.30 |
2 |
12 years |
|
2.31 - 3.44 |
3 |
9 years |
|
3.45 - 4.37 |
4 |
4 years |
|
> 4.37 |
5 |
2 years |
Limitation:
• The study was done at a single medical center.
Purpose: To evaluate a patient with primary sclerosing cholangitis (PSC) using the prognostic score of Tischendorf et al.
Specialty: Gastroenterology, Immunology/Rheumatology
Objective: other testing, severity, prognosis, stage, options, selection
ICD-10: K83.0,
