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


CONCLUSIONS
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.
Su
Chien-Wei
CW
Department of Medicine, Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.
Hung
Hung-Hsu
HH
Huo
Teh-Ia
TI
Huang
Yi-Hsiang
YH
Li
Chung-Pin
CP
Lin
Han-Chieh
HC
Lee
Pui-Ching
PC
Lee
Shou-Dong
SD
Wu
Jaw-Ching
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008105:Liver Cirrhosis, Biliary / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D008113:Liver Neoplasms / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
D012709:Serum Albumin; D001663:Bilirubin