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

作者：Suzuki Yutaka^*; Mori Toshiyuki; Yokoyama Masaaki; Kim Sangchul; Momose Hirokazu; Matsuki Ryota; Kogure Masaharu; Abe Nobutsugu; Isayama Hiroyuki; Nakazawa Takahiro; Notohara Kenji; Tanaka Atsushi; Tsuyuguchi Toshio; Tazuma Susumu; Takikawa Hajime; Sugiyama Masanori

来源：Journal of Gastroenterology, 2018, 53(7): 854-860.

DOI：10.1007/s00535-017-1410-6

• Hepatolithiasis
• Cohort study
• Prognosis
• Intrahepatic cholangiocarcinoma
• Liver cirrhosis

Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system.
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.
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 ae 65 years at the time of initial diagnosis [hazard ratio (HR) 3.410], jaundice for ae 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 ae 65 years and jaundice for ae 1 week during follow-up as minor factors. Survival rates differed significantly between grades.
The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes.

• 出版日期2018-7