A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort.

Abstract:

BACKGROUND:Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system. METHODS:The study cohort comprised 396 patients who were identified through a 1998 nationwide survey and followed up for 18 years or until death. Cox regression analysis was used to identify prognostic factors. RESULTS:Median survival time of the patients was 308 (range 0-462) months. Of the 396 patients enrolled in the study, 118 (29.8%) died, most frequently from intrahepatic cholangiocarcinoma (25 patients, 21.2%). Age of ≥ 65 years at the time of initial diagnosis [hazard ratio (HR) 3.410], jaundice for ≥ 1 week during follow-up (HR 2.442), intrahepatic cholangiocarcinoma (HR 3.674), and liver cirrhosis (HR 5.061) were shown to be significant risk factors for death from any therapeutic course. The data led to a 3-grade disease severity classification system that incorporates intrahepatic cholangiocarcinoma and liver cirrhosis as major factors and age of ≥ 65 years and jaundice for ≥ 1 week during follow-up as minor factors. Survival rates differed significantly between grades. CONCLUSIONS:The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes.

journal_name

J Gastroenterol

authors

Suzuki Y,Mori T,Yokoyama M,Kim S,Momose H,Matsuki R,Kogure M,Abe N,Isayama H,Nakazawa T,Notohara K,Tanaka A,Tsuyuguchi T,Tazuma S,Takikawa H,Sugiyama M

doi

10.1007/s00535-017-1410-6

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

854-860

issue

7

eissn

0944-1174

issn

1435-5922

pii

10.1007/s00535-017-1410-6

journal_volume

53

pub_type

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