Primary sclerosing cholangitis: Refinement and validation of survival models
The natural history of primary sclerosing cholangitis was studied in 426 patients from five medical centers. The median follow-up time was 3.0 years (range, 0.01–16.6 years); 100 patients had died by the time of last follow-up. Survival analysis (Cox proportional-hazards regression) was used to iden...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 1992-12, Vol.103 (6), p.1893-1901 |
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| container_title | Gastroenterology (New York, N.Y. 1943) |
| container_volume | 103 |
| creator | Dickson, E.Rolland Murtaugh, Paul A. Wiesner, Russell H. Grambsch, Patricia M. Fleming, Thomas R. Ludwig, Jurgen LaRusso, Nicholas F. Malinchoc, Michael Chapman, Roger W. Kaplan, Marshall M. Maddrey, Willis C. Williams, Roger Farrant, Mark Langworthy, Alice |
| description | The natural history of primary sclerosing cholangitis was studied in 426 patients from five medical centers. The median follow-up time was 3.0 years (range, 0.01–16.6 years); 100 patients had died by the time of last follow-up. Survival analysis (Cox proportional-hazards regression) was used to identify the variables most useful in predicting survival of patients with primary sclerosing cholangitis. Serum bilirubin concentration, histological stage on liver biopsy, age, and the presence of splenomegaly were independent predictors of a high risk of dying. A mathematical model to predict survival of patients with primary sclerosing cholangitis (based on referral values of those predictors) was statistically validated using two methods. Confidence intervals for predicting patient-specific survival probabilities are also presented. This model to predict survival could be used to stratify participants in therapeutic trials, counsel patients and their families, decide on candidacy for and timing of liver transplantation, and provide mathematical controls for evaluating the efficacy of therapies for primary sclerosing cholangitis, including transplantation. |
| doi_str_mv | 10.1016/0016-5085(92)91449-E |
| format | Article |
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The median follow-up time was 3.0 years (range, 0.01–16.6 years); 100 patients had died by the time of last follow-up. Survival analysis (Cox proportional-hazards regression) was used to identify the variables most useful in predicting survival of patients with primary sclerosing cholangitis. Serum bilirubin concentration, histological stage on liver biopsy, age, and the presence of splenomegaly were independent predictors of a high risk of dying. A mathematical model to predict survival of patients with primary sclerosing cholangitis (based on referral values of those predictors) was statistically validated using two methods. Confidence intervals for predicting patient-specific survival probabilities are also presented. This model to predict survival could be used to stratify participants in therapeutic trials, counsel patients and their families, decide on candidacy for and timing of liver transplantation, and provide mathematical controls for evaluating the efficacy of therapies for primary sclerosing cholangitis, including transplantation.</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1016/0016-5085(92)91449-E</identifier><identifier>PMID: 1451982</identifier><identifier>CODEN: GASTAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Bilirubin - blood ; Biological and medical sciences ; Cholangitis, Sclerosing - mortality ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Models, Statistical ; Multivariate Analysis ; Other diseases. Semiology ; Probability ; Regression Analysis ; Survival Rate</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 1992-12, Vol.103 (6), p.1893-1901</ispartof><rights>1992</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-ce81a02aab854f23619c31c9dc85d22a6bf30ded24bd6f27bde20349ecd969783</citedby><cites>FETCH-LOGICAL-c452t-ce81a02aab854f23619c31c9dc85d22a6bf30ded24bd6f27bde20349ecd969783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/001650859291449E$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4432928$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1451982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dickson, E.Rolland</creatorcontrib><creatorcontrib>Murtaugh, Paul A.</creatorcontrib><creatorcontrib>Wiesner, Russell H.</creatorcontrib><creatorcontrib>Grambsch, Patricia M.</creatorcontrib><creatorcontrib>Fleming, Thomas R.</creatorcontrib><creatorcontrib>Ludwig, Jurgen</creatorcontrib><creatorcontrib>LaRusso, Nicholas F.</creatorcontrib><creatorcontrib>Malinchoc, Michael</creatorcontrib><creatorcontrib>Chapman, Roger W.</creatorcontrib><creatorcontrib>Kaplan, Marshall M.</creatorcontrib><creatorcontrib>Maddrey, Willis C.</creatorcontrib><creatorcontrib>Williams, Roger</creatorcontrib><creatorcontrib>Farrant, Mark</creatorcontrib><creatorcontrib>Langworthy, Alice</creatorcontrib><title>Primary sclerosing cholangitis: Refinement and validation of survival models</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>The natural history of primary sclerosing cholangitis was studied in 426 patients from five medical centers. The median follow-up time was 3.0 years (range, 0.01–16.6 years); 100 patients had died by the time of last follow-up. Survival analysis (Cox proportional-hazards regression) was used to identify the variables most useful in predicting survival of patients with primary sclerosing cholangitis. Serum bilirubin concentration, histological stage on liver biopsy, age, and the presence of splenomegaly were independent predictors of a high risk of dying. A mathematical model to predict survival of patients with primary sclerosing cholangitis (based on referral values of those predictors) was statistically validated using two methods. Confidence intervals for predicting patient-specific survival probabilities are also presented. This model to predict survival could be used to stratify participants in therapeutic trials, counsel patients and their families, decide on candidacy for and timing of liver transplantation, and provide mathematical controls for evaluating the efficacy of therapies for primary sclerosing cholangitis, including transplantation.</description><subject>Adult</subject><subject>Aged</subject><subject>Bilirubin - blood</subject><subject>Biological and medical sciences</subject><subject>Cholangitis, Sclerosing - mortality</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Statistical</subject><subject>Multivariate Analysis</subject><subject>Other diseases. Semiology</subject><subject>Probability</subject><subject>Regression Analysis</subject><subject>Survival Rate</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEUhYMotVb_gcIsRHQxmud04kKQUh9QUETXIZPcqZF5aDJT8N-bOqXu3ORCzrmXcz6Ejgm-JJhkVzg-qcC5OJf0QhLOZTrfQWMiaJ5Gje6i8dayjw5C-MAYS5aTERoRLojM6Rgtnr2rtf9OgqnAt8E1y8S8t5Vulq5z4Tp5gdI1UEPTJbqxyUpXzurOtU3Slkno_crFr6RuLVThEO2VugpwtJkT9HY3f509pIun-8fZ7SI1XNAuNZATjanWRS54SVlGpGHESGtyYSnVWVEybMFSXtispNPCAsWMSzBWZnKaswk6G-5--varh9Cp2gUDVUwNbR_UlDEuYvVo5IPRxGrBQ6k-h7qKYLWGqNaE1JqQklT9QlTzuHayud8XNdi_pYFa1E83ug5GV6XXjXFha-OcUUnXMW8GW0QDKwdeBeOgMWCdB9Mp27r_c_wAEbWOcg</recordid><startdate>19921201</startdate><enddate>19921201</enddate><creator>Dickson, E.Rolland</creator><creator>Murtaugh, Paul A.</creator><creator>Wiesner, Russell H.</creator><creator>Grambsch, Patricia M.</creator><creator>Fleming, Thomas R.</creator><creator>Ludwig, Jurgen</creator><creator>LaRusso, Nicholas F.</creator><creator>Malinchoc, Michael</creator><creator>Chapman, Roger W.</creator><creator>Kaplan, Marshall M.</creator><creator>Maddrey, Willis C.</creator><creator>Williams, Roger</creator><creator>Farrant, Mark</creator><creator>Langworthy, Alice</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19921201</creationdate><title>Primary sclerosing cholangitis: Refinement and validation of survival models</title><author>Dickson, E.Rolland ; Murtaugh, Paul A. ; Wiesner, Russell H. ; Grambsch, Patricia M. ; Fleming, Thomas R. ; Ludwig, Jurgen ; LaRusso, Nicholas F. ; Malinchoc, Michael ; Chapman, Roger W. ; Kaplan, Marshall M. ; Maddrey, Willis C. ; Williams, Roger ; Farrant, Mark ; Langworthy, Alice</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-ce81a02aab854f23619c31c9dc85d22a6bf30ded24bd6f27bde20349ecd969783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bilirubin - blood</topic><topic>Biological and medical sciences</topic><topic>Cholangitis, Sclerosing - mortality</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Statistical</topic><topic>Multivariate Analysis</topic><topic>Other diseases. Semiology</topic><topic>Probability</topic><topic>Regression Analysis</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dickson, E.Rolland</creatorcontrib><creatorcontrib>Murtaugh, Paul A.</creatorcontrib><creatorcontrib>Wiesner, Russell H.</creatorcontrib><creatorcontrib>Grambsch, Patricia M.</creatorcontrib><creatorcontrib>Fleming, Thomas R.</creatorcontrib><creatorcontrib>Ludwig, Jurgen</creatorcontrib><creatorcontrib>LaRusso, Nicholas F.</creatorcontrib><creatorcontrib>Malinchoc, Michael</creatorcontrib><creatorcontrib>Chapman, Roger W.</creatorcontrib><creatorcontrib>Kaplan, Marshall M.</creatorcontrib><creatorcontrib>Maddrey, Willis C.</creatorcontrib><creatorcontrib>Williams, Roger</creatorcontrib><creatorcontrib>Farrant, Mark</creatorcontrib><creatorcontrib>Langworthy, Alice</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dickson, E.Rolland</au><au>Murtaugh, Paul A.</au><au>Wiesner, Russell H.</au><au>Grambsch, Patricia M.</au><au>Fleming, Thomas R.</au><au>Ludwig, Jurgen</au><au>LaRusso, Nicholas F.</au><au>Malinchoc, Michael</au><au>Chapman, Roger W.</au><au>Kaplan, Marshall M.</au><au>Maddrey, Willis C.</au><au>Williams, Roger</au><au>Farrant, Mark</au><au>Langworthy, Alice</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Primary sclerosing cholangitis: Refinement and validation of survival models</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>1992-12-01</date><risdate>1992</risdate><volume>103</volume><issue>6</issue><spage>1893</spage><epage>1901</epage><pages>1893-1901</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><coden>GASTAB</coden><abstract>The natural history of primary sclerosing cholangitis was studied in 426 patients from five medical centers. The median follow-up time was 3.0 years (range, 0.01–16.6 years); 100 patients had died by the time of last follow-up. Survival analysis (Cox proportional-hazards regression) was used to identify the variables most useful in predicting survival of patients with primary sclerosing cholangitis. Serum bilirubin concentration, histological stage on liver biopsy, age, and the presence of splenomegaly were independent predictors of a high risk of dying. A mathematical model to predict survival of patients with primary sclerosing cholangitis (based on referral values of those predictors) was statistically validated using two methods. Confidence intervals for predicting patient-specific survival probabilities are also presented. This model to predict survival could be used to stratify participants in therapeutic trials, counsel patients and their families, decide on candidacy for and timing of liver transplantation, and provide mathematical controls for evaluating the efficacy of therapies for primary sclerosing cholangitis, including transplantation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1451982</pmid><doi>10.1016/0016-5085(92)91449-E</doi><tpages>9</tpages></addata></record> |
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| ispartof | Gastroenterology (New York, N.Y. 1943), 1992-12, Vol.103 (6), p.1893-1901 |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Bilirubin - blood Biological and medical sciences Cholangitis, Sclerosing - mortality Female Gastroenterology. Liver. Pancreas. Abdomen Humans Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Models, Statistical Multivariate Analysis Other diseases. Semiology Probability Regression Analysis Survival Rate |
| title | Primary sclerosing cholangitis: Refinement and validation of survival models |
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