Please use this identifier to cite or link to this item: http://ir.swu.ac.th/jspui/handle/123456789/13368
Title: Prognostic values of serum bilirubin at 7th day post-Kasai for survival with native livers in patients with biliary atresia
Authors: Chusilp S.
Sookpotarom P.
Tepmalai K.
Rajatapiti P.
Chongsrisawat V.
Poovorawan Y.
Vejchapipat P.
Keywords: bilirubin
bilirubin
Article
bile duct atresia
bilirubin blood level
female
follow up
human
infant
jaundice
logistic regression analysis
major clinical study
male
newborn
outcome assessment
overall survival
portoenterostomy
postoperative period
predictive value
preoperative period
priority journal
prognosis
proportional hazards model
survival
survival analysis
survival rate
survival time
Biliary Atresia
blood
liver
mortality
odds ratio
portoenterostomy
postoperative complication
prognosis
treatment outcome
Biliary Atresia
Bilirubin
Female
Humans
Infant
Infant, Newborn
Liver
Male
Odds Ratio
Portoenterostomy, Hepatic
Postoperative Complications
Postoperative Period
Prognosis
Survival Analysis
Survival Rate
Treatment Outcome
Issue Date: 2016
Abstract: Background: Biliary atresia (BA) is a serious liver disease with uncertain prognosis. The objective of this study was to investigate prognostic values of the >20 % decrease in serum total bilirubin (TB) at 7th day post-op regarding early outcome and 5-year survival with native liver in BA. Methods: Biliary atresia patients undergoing Kasai operation between 2000 and 2014 were reviewed. The ratio of serum TB at 7th day post-op to pre-op TB levels (TB7/TB0) was calculated for every patient. TB7/TB0 ratio of <0.8 indicated the >20 % decrease in serum TB. At 6th month following Kasai operation, outcome of BA patients were categorized into good outcome (TB < 2 mg % or clinically jaundice free) and poor outcome (TB > 2 mg % or clinically jaundice). For outcome analysis, logistic regression was used. For survival analysis, Cox regression was applied. Results: There were 133 BA patients (M:F = 68:65) undergoing Kasai operation. Median age at surgery was 79 days. BA patients with TB7/TB0 ratio of <0.8 were found in 38 %. Outcome at 6-month post-op could be evaluated in 126 patients (good: poor = 68:58). The 1-, 3- and 5-year survival rates with native livers were 85, 70 and 65 %, respectively. The median overall survival with native livers was 164 months. Median follow-up time was 87 months. Logistic regression showed that gender and age at operation were not significant factors impacting on early outcome (p > 0.05). However, TB7/TB0 ratio of <0.8 was an independent factor for good outcome (Odds ratio = 3.0, p = 0.006). Cox regression analysis demonstrated that 5-year survival rate was significantly correlated with TB7/TB0 ratio of <0.8 (HR = 0.46, 95 % CI 0.23–0.91, p = 0.025) and outcome at 6th month post-op (HR = 0.05, 95 % CI 0.01–0.15, p < 0.001). Conclusions: The >20 % decrease in serum TB at 7th day post-Kasai is a predictor for good outcome. BA patients with TB7/TB0 of <0.8 had 5-year survival with native livers significantly higher than those with the ratio of >0.8. © 2016, Springer-Verlag Berlin Heidelberg.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84980010311&doi=10.1007%2fs00383-016-3951-9&partnerID=40&md5=8a7e4f8a627c9eb83183bffab5b395e7
http://ir.swu.ac.th/jspui/handle/123456789/13368
ISSN: 1790358
Appears in Collections:Scopus 1983-2021

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