Natural history and prognostic factors of primary biliary cirrhosis in Taiwan: a follow-up study up to 18 years

Liver Int. 2008 Nov;28(9):1305-13. doi: 10.1111/j.1478-3231.2008.01715.x. Epub 2008 Mar 13.

Abstract

Purpose: The natural history of primary biliary cirrhosis (PBC) has been little studied in Asia. We conducted a Taiwanese cohort study on the natural history of PBC and analysed the prognostic factors.

Methods: This study enrolled 96 consecutive PBC patients between 1985 and 2006 to evaluate the baseline characteristics and outcomes.

Results: There were 74 females and 22 males. Eighty-five were positive for antimitochondrial antibodies in sera, and 11 were negative. The clinical manifestations and prognosis were similar between these two groups. In a median follow-up of 47.5+/-55.8 months, 27 patients died. Multivariate analysis indicated that the independent prognostic factors were serum albumin (P=0.021), creatinine (P=0.033) and ursodeoxycholic acid treatment (P=0.008). Besides, 42 patients developed adverse outcomes. Albumin (P<0.001), bilirubin (P=0.019) and prothrombin time (PT) (P=0.010) were significant factors. Moreover, a Mayo risk score <5, a Model for End-Stage Liver Disease (MELD) score <6, a Child-Pugh stage A and early liver histology were associated with favourable outcomes.

Conclusion: Serum albumin, bilirubin and PT were independent prognostic factors of adverse outcomes for Taiwanese PBC patients. Besides, the Mayo risk score, the MELD score, the Child-Pugh stage and liver histology were also validated to predict survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bilirubin / blood
  • Carcinoma, Hepatocellular / etiology
  • Cohort Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Cirrhosis, Biliary / blood*
  • Liver Cirrhosis, Biliary / complications
  • Liver Cirrhosis, Biliary / diagnosis
  • Liver Cirrhosis, Biliary / mortality
  • Liver Neoplasms / etiology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Retrospective Studies
  • Serum Albumin / analysis
  • Taiwan / epidemiology
  • Treatment Outcome

Substances

  • Serum Albumin
  • Bilirubin