Development and validation of a prognostic score for long-term transplant-free survival in autoimmune hepatitis type 1.
Autor: | Biewenga M; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands., Verhelst XPDMJ; Department of Gastroenterology and Hepatology, UZ Ghent, Ghent, Belgium., Baven-Pronk MAMC; Department of Gastroenterology and Hepatology, Green Heart Hospital, Gouda, the Netherlands., Putter H; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands., van den Berg AP; Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands., van Nieuwkerk KCMJ; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands., van Buuren HR; Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, the Netherlands., Bouma G; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands., de Boer YS; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands., Simoen C; Department of Gastroenterology and Hepatology, UZ Ghent, Ghent, Belgium., Colle I; Department of Gastroenterology and Hepatology, ASZ Aalst, Aalst, Belgium., Schouten J; Department of Gastroenterology and Hepatology, AZ Nikolaas, Sint-Niklaas, Belgium., Sermon F; Department of Gastroenterology and Hepatology, OLV Aalst, Aalst, Belgium., van Steenkiste C; Department of Gastroenterology and Hepatology, AZ Maria Middelares Ghent, Ghent, Belgium.; Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium., van Vlierberghe H; Department of Gastroenterology and Hepatology, UZ Ghent, Ghent, Belgium., van der Meer AJ; Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, the Netherlands., Nevens F; Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium., van Hoek B; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands. |
---|---|
Jazyk: | angličtina |
Zdroj: | United European gastroenterology journal [United European Gastroenterol J] 2021 Jul; Vol. 9 (6), pp. 662-671. Date of Electronic Publication: 2021 Jun 24. |
DOI: | 10.1002/ueg2.12112 |
Abstrakt: | Background: No prognostic score is currently available for long-term survival in autoimmune hepatitis (AIH) patients. Objective: The aim of this study was to develop and validate such a prognostic score for AIH patients at diagnosis. Methods: The prognostic score was developed using uni- & multivariate Cox regression in a 4-center Dutch cohort and validated in an independent 6-center Belgian cohort. Results: In the derivation cohort of 396 patients 19 liver transplantations (LTs) and 51 deaths occurred (median follow-up 118 months; interquartile range 60-202 months). In multivariate analysis age (hazard ratio [HR] 1.045; p < 0.001), non-caucasian ethnicity (HR 1.897; p = 0.045), cirrhosis (HR 3.266; p < 0.001) and alanine aminotransferase level (HR 0.725; p = 0.003) were significant independent predictors for mortality or LT (C-statistic 0.827; 95% CI 0.790-0.864). In the validation cohort of 408 patients death or LT occurred in 78 patients during a median follow-up of 74 months (interquartile range: 25-142 months). Predicted 5-year event rate did not differ from observed event rate (high risk group 21.5% vs. 15.7% (95% CI: 6.3%-24.2%); moderate risk group 5.8% versus 4.3% (95% CI: 0.0%-9.1%); low risk group 1.9% versus 5.4% (95% CI: 0.0%-11.4%); C-statistic 0.744 [95% CI 0.644-0.844]). Conclusions: A Dutch-Belgian prognostic score for long-term transplant-free survival in AIH patients at diagnosis was developed and validated. (© 2021 The Authors. UEG Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.) |
Databáze: | MEDLINE |
Externí odkaz: |