Serum bilirubin: a prognostic factor in primary biliary cirrhosis
Open accessAbstract
We followed up 55 patients with proven primary biliary cirrhosis for several years or until death. A graph of the level of serum bilirubin versus time that was constructed for each patient shows an initial period of variable length in which the serum bilirubin level remained constant. This was followed by a period of rapid rise in serum bilirubin which culminated in the patient's death. Whenever two successive serum bilirubin values taken six months apart exceeded 34 mumol/l (2.0 mg/dl) the patient had entered a late phase of disease and lived an average of 49 months. Ninety-five per cent confidence limits on survival time were 32-74 months. If two successive six month bilirubin values exceeded 102 mumol/l (6.0 mg/dl), calculated survival time was 25 months, and if two successive six month bilirubin values exceeded 170 mumol/l (10.0 mg/dl), survival time was 17 months. Fifteen of the 41 living patients had two consecutive serum bilirubin levels greater than 34 mumol/l (2.0 mg/dl). However, the slope of the rising bilirubin in the living patients is only 35 mumol/l/yr (1.5 mg/dl/yr) compared with 42 mumol/l/yr (2.5 mg/dl/yr) in the dead patients. This means that patients with this disease not may be living considerably longer.
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Mean survival once the bilirubin is 34 μmol/L is 4 years, and when the bilirubin reaches 102 μmol/L mean survival is only 2 years.
“mean survival once the bilirubin is 34 μmol/L is 4 years, and when the bilirubin reaches 102 μmol/L mean survival is only 2 years.132”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [132]
The Presentation table reports geometric mean survival of 49 months above 34 μmol/L and 25 months above 102 μmol/L, approximately four and two years. But these estimates apply after two successive bilirubin measurements six months apart exceed the thresholds, not when a single measurement reaches them; the Discussion reiterates this condition. Page numbers are not provided in the supplied passages. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSerum bilirubin has been recognized since the 1970s as a major predictor of poor PBC outcome.
“Serum bilirubin has been recognised since the 1970s as a major predictor of poor outcome in PBC [72,7].”
From EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. (2017) · cites this paper as [72]
Serum bilirubin has been recognised since the 1970s as a major predictor of poor outcome in PBC.
“Serum bilirubin has been recognised since the 1970s as a major predictor of poor outcome in PBC [72,7].”
From EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. (2017) · cites this paper as [72]
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- Authors
- Shapiro, J. M., Smith, H., & Schaffner, F.
- Affiliations
- City University of New York (US)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1979-02
- Volume
- 20
- Issue
- 2
- Pages
- 137-140
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1419455
- OpenAlex
- W1975579398
- Semantic Scholar
- 5db469a0030e3c8b406982f871318edde62e9b2a
- Cited by
- 319
- References
- 14
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 2 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 5 · 2015: 12 · 2014: 6 · 2013: 2 · 2012: 8
- FWCI
- 5.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- primary biliary cirrhosis, serum bilirubin, prognostic factors, survival time, disease progression, bilirubin kinetics, mortality
- MeSH terms
- Adult, Aged, Bilirubin, Female, Follow-Up Studies, Humans, Liver Cirrhosis, Biliary, Male, Middle Aged, Prognosis
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