Conditional probability of survival in patients with biliary atresia after Kasai portoenterostomy: a Chinese population-based study.
Survival estimates are commonly reported for the outcomes of patients. Conditional probability, which offers more relevant information regarding the prognosis for patients once they have survived for some time, are lacking for patients with biliary atresia. The aim of this study is to calculate the conditional probability of survival in patients with biliary atresia after Kasai portoenterostomy. Clinical data from 244 consecutive patients who underwent Kasai portoenterostomy were reviewed and the actuarial survival estimated. Conditional survival probabilities and 95% CIs were calculated. Of the 244 patients, the overall median NLS was 41.2 months (95% CI:30.8-51.6 months), and the 1-year, 3-year, and 5-year NLS rates were 85.4%, 61.1%, and 43.3%, respectively. The probabilities of surviving at the time point of 5 years given survival to 1, 2, 3, and 4 years were 50%, 56%, 73%, and 93%, respectively. For conditional survival for 1 additional year, patients with age >90 days and cholangitis had significantly predictive values(both P<0.05). Cox proportional hazards model showed that age > 90 days(HR: 2.519, P=0.001), and postoperative cholangitis(HR:2.568, P<0.001) were associated with an adverse NLS in the multivariable adjusted analysis. our findings showed that conditional survival of patients with BA is not linear over time after Kasai operation. Information derived from conditional survival can be used to better manage patients with BA, including the potential subsequent treatment decisions, the chance of listing for transplantation, or even the end-of-life planning.
Graduate School of Peking Union Medical College, Beijing, People's Republic of China; Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.
Guoliang
G
Qiao
Graduate School of Peking Union Medical College, Beijing, People's Republic of China; Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China. Electronic address: lilongcip@163.com.
Long
L
Li
Department of Surgery, United Family Hospital, Beijing, People's Republic of China; Department of Paediatrics and Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.
Wei
W
Cheng
Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.
Zhen
Z
Zhang
Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.
Juntao
J
Ge
Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.
Chen
C
Wang
D001656:Biliary Atresia / Q000401:mortality* / Q000601:surgery; D002675:Child, Preschool; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011171:Portoenterostomy, Hepatic; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
Biliary atresia; Conditional survival; Kasai portoenterostomy