Z Gastroenterol 2015; 53 - A2_32
DOI: 10.1055/s-0035-1568004

Natural course and prognostic factors in patients with cholestatic liver disease – experience from a single center study

L Adam 1, D Bettinger 1, R Thimme 1, T Boettler 1
  • 1University Hospital Freiburg, Department of Internal Medicine II, Freiburg, Germany

Background and Aims:

Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the most common cholestatic liver diseases. However, the clinical course of PBC and PSC differs significantly among individuals and therefore scores using disease-specific parameters are necessary to identify patients who are at high risk developing complications with impaired prognosis. The aim of our study was to analyze the typical characteristics of patients with PSC and PBC focusing on treatment, prognostic factors and the prognostic significance of the recently established albumin-bilirubin (ALBI) score.

Methods:

338 patients with PSC/PBC who were treated at our Liver Unit between 1996 and 2015 were included in the analyses. Medical records, laboratory parameters, treatment, transplant-free survival and overall survival (OS) were assessed.

Results:

214 patients with PBC (89.3% female, median age 64 years) and 124 patients with PSC (67.7% male, median age 49 years) were included in the analyses. 71.8% of patients with PSC had concurrent IBD, especially ulcerative colitis (80.9%), compared to 1.4% of PBC patients. Significantly more patients with PSC developed colorectal neoplasia compared to PBC patients (11.3% vs. 1.4%). Patients with PSC showed higher ALBI score values than PBC patients (p < 0.001) indicating more severe liver disease. Bilirubin (HR 1.35; 95% Cl: 1.14 – 1.61; p = 0.001) was the strongest significant negative prognostic factor for transplant-free survival. Adding albumin as a marker of liver function, the ALBI score significantly identifies patients with worse prognosis.

Conclusion:

The ALBI score can be used to assess liver function, disease severity and OS in patients with cholestatic liver disease. Further analyses evaluating correlations between the ALBI score and the clinical course of disease in PBC and PSC patients are warranted.

Corresponding author: Bettinger, Dominik

E-Mail: dominik.bettinger@uniklinik-freiburg.de