TABLE 3.
Prognostic scores for PSC
| Prognostic score | Variables included | Goal |
|---|---|---|
| Adult | ||
| Revised Mayo risk score | Age, bilirubin, albumin, AST, history of variceal bleeding | Estimates overall survival up to 4 y of follow-up. |
| Amsterdam-Oxford model | PSC subtype, bilirubin, albumin, ALP, AST, platelets, age at PSC diagnosis | Estimates transplant-free survival at 5, 10, and 15 y of follow-up. C-statistic = 0.68 |
| UK-PSC score | Age at diagnosis, bilirubin at diagnosis, albumin at diagnosis, platelets at diagnosis, hemoglobin at diagnosis, ALP at year 2, disease type (presence of extrahepatic disease), history of variceal bleeding by year 2 | Estimates transplant-free survival at 2 and 10 y of follow-up. C-statistic = 0.80 |
| PSC risk estimate tool (PREsTo) | Age, ALP, AST, bilirubin, albumin, sodium, hemoglobin, platelets, number of years since PSC was diagnosed | Predicts 5-y probability of hepatic decompensation. C-statistic = 0.90 |
| Pediatric | ||
| Sclerosing Cholangitis Outcomes in Pediatrics (SCOPE) Index | Bilirubin, albumin, platelet count, GGT, cholangiography (normal or large-duct involvement) | Predicts LT or death (TD) and hepatobiliary complications (HBCs = portal hypertensive, biliary, and cancer complications) within 5 y of follow-up. Validated for patients <18 years of age. C-statistics = 0.82 for TD and 0.76 for HBCs |
| Radiology | ||
| DiStrict score | MRCP-defined ductal stricture with or without upstream dilatation and extent of ductal involvement | Predicts survival without liver-related outcomes (LT and liver-related death) through MRCP result. C-statistic = 0.78 |
| qMRCP-PSC score | Artificial intelligence-driven analysis of MRCP-3D images | Predicts hepatobiliary complications, defined as the earliest occurring event among the following: (1) listing for LT; (2) liver-related death; (3) diagnosis of portal hypertensive complications such as ascites requiring hospital admission or diuretic therapy and HE requiring hospital admission; (4) gastroesophageal bleeding; (5) diagnosis of biliary complications (biliary strictures requiring dilation, stenting or external drainage, or hospitalization for acute bacterial cholangitis); (6) diagnosis of cholangiocarcinoma. C-statistic = 0.80 |
Note: C-statistics for risk scores are provided as per original studies. A C-statistic of 0.5 means that there is no predictive power at all, and 1.0 means perfect prediction of the outcome.
Abbreviations: HBC, hepatobiliary complications; LT, liver transplantation; MRCP, magnetic resonance cholangiopancreatography; PSC, primary sclerosing cholangitis; TD, liver transplantation or death.