Score of Pausawasdi et al for Predicting Successful Endobiliary Stenting of a Malignant Biliary Obstruction: Reduction of Total Serum Bilirubin Within 2 Weeks
Pausawasdi et al reported scores for predicting various measures of success following endobiliary stenting of a malignant biliary obstruction. One equation predicts success within 2 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) pre-endoscopic serum ALP level as multiple of the upper limit of normal (ULN)
(3) peritoneal carcinomatosis
(4) material of the endobiliary stent
Parameter
Finding
Points
extrahepatic biliary obstruction
no
0
yes
5
serum ALP
0.5 * (serum ALP) / (ULN)
peritoneal carcinomatosis
no
0
yes
-4
endobiliary stent
metal
0
plastic
-4
total score =
= SUM(points for all of the parameters) + 2
Interpretation:
• minimum score: between -7 and -8
• maximum score: around 18
• The higher the score the greater the chances of success.
Total Score
Bilirubin Reduction
LT -5.22
6%
-5.22 to -2.98
15%
-2.99 to -1.03
26%
> -1.03
54%
Performance:
• The area under the ROC curve is 0.70 in the derivation and 0.67 in the validation cohort.
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