BACKGROUND: Current survival models for primary biliary cirrhosis have limited precision for medium and long-term survival. Aim To describe a prognostic model for the advent of complications in primary biliary cirrhosis as the first approach to a staged prognostic model. METHODS: From an established database of 289 consecutive primary biliary cirrhosis patients referred to Royal Free Hospital over 12 years (mean follow-up of 4.1 years), baseline characteristics at referral were evaluated by Cox-proportional hazards regression modelling. RESULTS: The following complications occurred de novo: 85 ascites/peripheral oedema, 40 oesophagogastric varices, 63 encephalopathy, 29 spontaneous bacterial peritonitis and/or septicaemia, 59 symptomatic urinary tract infections. Age, albumin, log(10)(bilirubin), presence of ascites at referral, variceal bleeding within 6 weeks before referral, detection of oesophagogastric varices at or before referral were significant at multivariate analysis with different combinations and coefficients for each complication. The model for predicting ascites and/or peripheral oedema best fitted the observed data (ROC = 0.7682, S.E. = 0.0385). CONCLUSIONS: The known prognostic factors in primary biliary cirrhosis also model the advent of complications. In view of the prognostic importance of ascites and its more robust statistical model, ascites and/or peripheral oedema could represent, following validation, the most suitable staged model in primary biliary cirrhosis to improve precision in survival modelling.
BACKGROUND: Current survival models for primary biliary cirrhosis have limited precision for medium and long-term survival. Aim To describe a prognostic model for the advent of complications in primary biliary cirrhosis as the first approach to a staged prognostic model. METHODS: From an established database of 289 consecutive primary biliary cirrhosispatients referred to Royal Free Hospital over 12 years (mean follow-up of 4.1 years), baseline characteristics at referral were evaluated by Cox-proportional hazards regression modelling. RESULTS: The following complications occurred de novo: 85 ascites/peripheral oedema, 40 oesophagogastric varices, 63 encephalopathy, 29 spontaneous bacterial peritonitis and/or septicaemia, 59 symptomatic urinary tract infections. Age, albumin, log(10)(bilirubin), presence of ascites at referral, variceal bleeding within 6 weeks before referral, detection of oesophagogastric varices at or before referral were significant at multivariate analysis with different combinations and coefficients for each complication. The model for predicting ascites and/or peripheral oedema best fitted the observed data (ROC = 0.7682, S.E. = 0.0385). CONCLUSIONS: The known prognostic factors in primary biliary cirrhosis also model the advent of complications. In view of the prognostic importance of ascites and its more robust statistical model, ascites and/or peripheral oedema could represent, following validation, the most suitable staged model in primary biliary cirrhosis to improve precision in survival modelling.
Authors: Maren H Harms; Willem J Lammers; Douglas Thorburn; Christophe Corpechot; Pietro Invernizzi; Harry L A Janssen; Pier M Battezzati; Frederik Nevens; Keith D Lindor; Annarosa Floreani; Cyriel Y Ponsioen; Marlyn J Mayo; George N Dalekos; Tony Bruns; Albert Parés; Andrew L Mason; Xavier Verhelst; Kris V Kowdley; Jorn C Goet; Gideon M Hirschfield; Bettina E Hansen; Henk R van Buuren Journal: Am J Gastroenterol Date: 2017-12-12 Impact factor: 10.864
Authors: V Papastergiou; E A Tsochatzis; M Rodriguez-Peralvarez; M Rodriquez-Peralvarez; E Thalassinos; G Pieri; P Manousou; G Germani; C Rigamonti; V Arvaniti; S Karatapanis; A K Burroughs Journal: Aliment Pharmacol Ther Date: 2013-10-05 Impact factor: 8.171
Authors: Emmanuel A Tsochatzis; Maurille Feudjo; Cristina Rigamonti; Jiannis Vlachogiannakos; James R Carpenter; Andrew K Burroughs Journal: Biomed Res Int Date: 2013-07-24 Impact factor: 3.411