1. Development and validation of a prognostic score for long-term transplant-free survival in autoimmune hepatitis type 1.
- Author
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Biewenga M, Verhelst XPDMJ, Baven-Pronk MAMC, Putter H, van den Berg AP, van Nieuwkerk KCMJ, van Buuren HR, Bouma G, de Boer YS, Simoen C, Colle I, Schouten J, Sermon F, van Steenkiste C, van Vlierberghe H, van der Meer AJ, Nevens F, and van Hoek B
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Belgium epidemiology, Child, Child, Preschool, Cohort Studies, Disease Progression, Disease-Free Survival, Female, Hepatitis, Autoimmune complications, Hepatitis, Autoimmune therapy, Humans, Liver Cirrhosis etiology, Male, Middle Aged, Multivariate Analysis, Netherlands epidemiology, Prognosis, Proportional Hazards Models, Reproducibility of Results, Risk Assessment, Risk Factors, Time Factors, Young Adult, Decision Support Techniques, Hepatitis, Autoimmune mortality, Liver Cirrhosis mortality, Liver Transplantation statistics & numerical data
- Abstract
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.)
- Published
- 2021
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