THE CHILD-PUGH CLASSIFICATION AS A PROGNOSTIC INDICATOR FOR SURVIVAL IN PRIMARY SCLEROSING CHOLANGITIS

Clinical decisions in primary sclerosing cholangitis (PSC) depend upon understanding its variable natural history, Several prognostic models for survival have been developed, We explored the Child-Pugh Classifi cation (CPC) to determine if it predicts survival as well, as a diseas e-specific model (DSM). We identified 208 PSC patients who satisfied e stablished criteria Prognostic variables were measured from the first visit. Kaplan-Meier survival estimates were obtained for CPC twice, on ce censoring observations at orthotopic liver transplantation and agai n considering opthotopic liver transplantation as a failure. A stepwis e Cox proportional hazards-model was used to identify the factors asso ciated with mortality. For 208 patients, the mean follow-up was 70 mon ths (SD + 55), Kaplan-Meier 7-year survivals for CPC A, B, and C were 89.8%, 68%, and 24.9%, respectively (P < .001). The Cox model identifi ed CPC and age as the most significant predictors of mortality. Adding the DSM risk score did not significantly improve the fit of the model (P = .75). The following were concluded: 1) CPC is a powerful predict or of survival in PSC; 2) DSM does not enhance the predictive ability of CPC; and 3) CPC may be used as an alternative to the DSM in researc h studies and clinical decision-making.