PRIMARY SCLEROSING CHOLANGITIS - CLINICAL PRESENTATION, NATURAL-HISTORY AND PROGNOSTIC VARIABLES - AN ITALIAN MULTICENTER STUDY

Citation
L. Okolicsanyi et al., PRIMARY SCLEROSING CHOLANGITIS - CLINICAL PRESENTATION, NATURAL-HISTORY AND PROGNOSTIC VARIABLES - AN ITALIAN MULTICENTER STUDY, European journal of gastroenterology & hepatology, 8(7), 1996, pp. 685-691
Citations number
42
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
0954-691X
Volume
8
Issue
7
Year of publication
1996
Pages
685 - 691
Database
ISI
SICI code
0954-691X(1996)8:7<685:PSC-CP>2.0.ZU;2-D
Abstract
Objective: Because large-scale reports of PSC in the Mediterranean are a are still lacking, in this study we evaluated by Kaplan-Meyer analys is the natural history of primary sclerosing cholangitis (PSC) in Ital y and by means of other statistical methods we identified the variable s most useful in predicting survival of such patients. Design: Retrosp ective multicentre study of unselected patients with PSC. Several vari ables involving sex, age, associated diseases, clinical features, labo ratory, cholangiographic and histological findings at presentation and clinical outcome at data recording were collected by means of a detai led questionnaire. Setting: 16 Italian university and regional hospita ls all over the country, thus giving a geographically representative p opulation. Patients: A total of 117 PSC patients (73 men and 44 women) ; median age 35 years. Methods: Survival analysis was performed by the Kaplan-Meyer method; the prognostic influence on survival of collecte d data was evaluated by univariate chi(2) analysis with Wilcoxon and l og-rank tests. The same prognostic variables were also evaluated by mu ltivariate analysis (Cox model), using a stepwise regression procedure . All statistical analyses were performed using the SAS statistical so ftware. Results: At presentation 70% of patients were symptomatic; sym ptoms did not relate to liver histology. Both intra- and extrahepatic bile duct lesions were detected in 46% of patients at cholangiography. Inflammatory bowel disease was found in 54% of symptomatic patients, ulcerative colitis was 36% of total. Clinical outcome (91/117): 15 und erwent liver transplantation or died from liver disease (cholangiocarc inoma). Survival at 10 years was 74%. Features of poor prognosis were cholesterol, aspartate aminotransferase (AST), haemoglobin and albumin . Conclusion: PSC in Italy mainly follows a benign course and among cl inical features recorded at presentation, serum cholesterol, AST, haem oglobin and albumin may provide some objective criteria to assess dise ase severity.