How does fatigue level affect the prognosis of primary biliary cholangitis (PBC)?

Updated: Nov 08, 2017
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Björnsson et al determined that fatigue levels may be a prognostic indicator for primary biliary cholangitis. [15] Among the 208 patients with the disease (16 males, 192 females, median age 59 years), the investigators recorded an overall baseline score of 28 on the fatigue impact scale (FIS). The score at follow-up (median 5 years)—at which time 186 patients were still alive, including 5 who had undergone liver transplantation—was 25. Specific baseline FIS scores were as follows:

  • Survivors (nontransplantation): 27 (12-43)

  • Nonsurvivors: 36 (12-72)

  • Patients who underwent liver transplantation: 99 (41-102)

In their report, Björnsson et al suggested that high fatigue levels can aid in predictions of liver-related mortality or liver transplantation need in patients with primary biliary cholangitis.

Age [hazard ratio (HR) 1.1 (confidence interval (CI) 1.0-1.2)] and aspartate aminotransferase [HR 2.0 (CI 1.3-3.0)] were independently associated with decreased survival on multivariate analysis. FIS scores over 40 [HR 9.6 (CI 2.3-39.7)] and bilirubin [HR 4.8 (CI 2.8-8.2)] were independently associated with a poor outcome in patients who underwent transplantation or had a liver-related death.


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