Description

Pausawasdi et al reported scores for predicting various measures of success following endobiliary stenting of a malignant biliary obstruction. One equation predicts normalization of total serum bilirubin within 6 weeks of the procedure. The authors are from Siriraj Hospital and Mahidol University in Bangkok.


Patient selection: malignant obstruction of bile duct

 

Parameters:

(1) extrahepatic biliary obstruction

(2) serum total bilirubin concentration prior to stent placement in mg/dL

(3) material used to make the endobiliary stent

 

Parameter

Finding

Points

extrahepatic biliary obstruction

no

0

 

yes

2

serum total bilirubin

 

-0.3 * (serum TB)

endobiliary stent

metal

0

 

plastic

-2

 

total score =

= SUM(points for all of the parameters) + 2

 

Interpretation:

• minimum score: around -13.6

• maximum score: around 3.6

• The higher the score the greater the chances of success.

• A score >= -2.44 had a sensitivity of 0.6-0.7 and specificity of 0.67-0.74.

• A score >= 1.3 had a high likelihood of bilirubin normalization within 6 weeks.

 

Performance:

• The area under the ROC curve is 0.78 in the derivation and 0.76 in the validation cohort.


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