Broome et al developed a prognostic index for Swedish patients with primary sclerosing cholangitis. This can aid in patient counseling and to help in deciding when transplantation is appropriate. The study was done at several university hospitals in Sweden and was based on data from 305 patients.
Parameters used in prognostic index:
(1) age of the patient in years
(2) serum total bilirubin
(3) histologic stage at diagnosis
|
Histology Stage at Time of Diagnosis |
Points |
|
I |
1 |
|
II |
1 |
|
III |
2 |
|
IV |
4 |
prognostic index =
= (0.24 * (points for histology stage)) + (0.03 * (age in years)) + (0.49 * LOG2(serum total bilirubin in µmol/L))
where:
• LOG2(X) = LN(X) / LN(2), with LN = natural logarithm in base e
• (0.49 * LOG2(serum total bilirubin)) = (0.7071 * LN(serum total bilirubin))
Interpretation:
• minimum score: theoretically around 2.5
• maximum score: theoretically around 9
• As the prognostic index increases, the median survival declines.
|
Prognostic Index |
Median Survival in Months |
|
3.4 |
156 |
|
3.6 |
146 |
|
3.8 |
142 |
|
4.0 |
120 |
|
4.2 |
114 |
|
4.4 |
102 |
|
4.6 |
90 |
|
4.8 |
72 |
|
5.0 |
60 |
|
5.2 |
50 |
|
5.4 |
42 |
|
5.6 |
36 |
|
5.8 |
28 |
|
6.0 |
24 |
|
6.2 |
18 |
|
6.4 |
18 |
|
6.6 |
16 |
|
6.8 |
12 |
|
7.0 |
10 |
|
7.2 |
8 |
|
7.4 |
6 |
|
7.6 |
6 |
|
>= 7.8 |
3 |
(from Figure 1, page 612)
|
Prognostic Index |
Approximation for Median Survival |
|
< 3.4 |
> 156 months |
|
3.4 to 5.4 |
363.45 - (60* (prognostic index)) |
|
5.4 to 7.8 |
(5.8192 * ((PI^2))) – (91.7 * (PI)) + 365.96 |
|
>= 7.8 |
3 months |
Specialty: Gastroenterology, Immunology/Rheumatology
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