PRIMARY BILIARY-CIRRHOSIS - PREDICTION OF SHORT-TERM SURVIVAL BASED ON REPEATED PATIENT VISITS
PRIMARY BILIARY-CIRRHOSIS - PREDICTION OF SHORT-TERM SURVIVAL BASED ON REPEATED PATIENT VISITS
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DOI：
10.1002/hep.1840200120
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发表时间：
1994-07-01
期刊：
影响因子：
13.5
通讯作者：
GIPS, CH
中科院分区：
文献类型：
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作者：
MURTAUGH, PA;DICKSON, ER;GIPS, CH
对1974年1月至1984年5月在梅奥诊所就诊的312例原发性胆汁性肝硬化的进展进行了研究。随访至1988年4月30日，140例患者死亡，29例患者行原位肝移植。这些患者共进行了1945次就诊，使我们能够研究原发性胆汁性肝硬化预后变量（年龄、胆红素值、白蛋白值、凝血酶原时间和水肿）从转诊时起的变化。此外，利用该数据库和Cox比例风险回归模型，我们开发了原发性胆汁性肝硬化的更新模型，可用于预测疾病过程中任何时间的短期生存。该模型使用最近一次患者就诊时测量的预后变量值。更新模型与原发性胆汁性肝硬化自然历史模型的预测生存期比较表明，更新模型在预测短期生存方面优于原始模型。这一发现既适用于梅奥诊所的患者，也适用于一组独立的83名荷兰患者。梅奥更新模型被推荐用于提高患者就诊后2年生存率预测的准确性。
The progression of primary biliary cirrhosis was studied in 312 patients who were seen at the Mayo Clinic between January 1974 and May 1984. Follow-up was extended to April 30, 1988, by which time 140 of the patients had died and 29 had undergone orthotopic liver transplantation. These patients generated 1,945 patient visits that enabled us to study the change in the prognostic variables of primary biliary cirrhosis (age, bilirubin value, albumin value, prothrombin time and edema) from the time of referral. Also, using this database and the Cox proportional-hazards regression model, we developed an updated model for primary biliary cirrhosis that can be used to predict short-term survival at any time in the course of the disease. This model uses the values of the prognostic variables measured at the latest patient visit. Comparison of predicted survival from the update model and the natural history model of primary biliary cirrhosis showed that the updated model was superior to the original model for predicting short-term survival. This finding applied to both the Mayo Clinic patients and an independent set of 83 Dutch patients. The Mayo updated model is recommended for improving the accuracy of predictions of survival during the 2 yr after a patient visit.