The Mayo risk score increases rapidly in the terminal phase of primary sclerosing cholangitis

Primary sclerosing cholangitis

“…To predict survival in an individual PSC patient, prognostic index formulae, which rely on Cox' s proportional hazards analysis with and without histological stage as a variable, have been reported. 42,74,77,78 Recently, the Child-Pugh classification has been evaluated as a prognostic indicator for survival in PSC. 79 The study demonstrates that the age-adjusted Child-Pugh model predicts survival before liver transplantation with accuracy similar to the Mayo PSC model; it has the advantage of not requiring complex mathematical computations, and it has been used in formulating minimal listing criteria for liver transplantation for the United Network for Organ Sharing.…”

“…82 The revised Mayo risk score is calculated using the formula: Risk ϭ 0.0295 · age in years ϩ 0.5373 · log bilirubin in milligrams per deciliter Ϫ 0.8389 · albumin ϩ 0.5380 · log aspartate transaminase in IU per liter ϩ 1.2426 · variceal bleeding. 78 One of the important challenges for today' s hepatologists is identifying not only which patients with PSC are in need of liver transplantation, but also when during the course of disease patients should be referred to optimize the results and minimize resource utilization. Undoubtedly, the major manifestations of chronic liver disease that prompt the clinical hepatologist to consider liver transplantation for other chronic liver disease also apply in PSC patients, such as the development of major complications related to portal hypertension, i.e., bleeding from gastroesophageal varices, diuretic-resistant ascites, and hepatic encephalopathy.…”

The Relative Role of the Child–Pugh Classification and the Mayo Natural History Model in the Assessment of Survival in Patients With Primary Sclerosing Cholangitis

“…The natural history of primary sclerosing cholangitis (PSC) has been the subject of a number of studies. [1][2][3][4][5] Most of the investigators employed the Cox proportional hazards analysis in assessing prognostic variables of patient survival. Certain variables have repeatedly been shown to have prognostic importance in these studies, which include patient age, bilirubin level, hepatosplenomegaly, and histological stage.…”

Primary Sclerosing Cholangitis

“…A relatively cumbersome mathematical model to predict survival (relative risk) included these variables: Modifi cations of this formula have also been devised for liver transplantation and shown to be accurate in studies by Kim et al [120]. In this abstract, a modified Mayo score was devised using the formula: Although somewhat cumbersome, this formula proved particularly important in assessing patients for liver transplantation, as those with low Mayo scores (<4.4) tended to have signifi cantly improved survival following liver transplantation than those with higher scores (>5.3).…”

“…In this abstract, a modified Mayo score was devised using the formula: Although somewhat cumbersome, this formula proved particularly important in assessing patients for liver transplantation, as those with low Mayo scores (<4.4) tended to have signifi cantly improved survival following liver transplantation than those with higher scores (>5.3). Furthermore, these same prognostic formulations have also been used to demonstrate that liver transplantation improves overall survival (when compared to predicted survival through the models) [120].…”