Glasgow Prognostic Score Predicts Hepatic Recompensation in Decompensated Primary Biliary Cholangitis: A Multicenter...

Area of Science:

• Hepatology
• Inflammation and Immunology
• Clinical Prognostics

Background:

• Chronic liver disease progression correlates with systemic inflammation and nutritional status.
• Decompensated primary biliary cholangitis (PBC) poses significant management challenges.
• Prognostic scoring systems are crucial for predicting outcomes in liver disease.

Purpose of the Study:

• To assess the prognostic value of the Glasgow Prognostic Score (GPS) for predicting recompensation in decompensated PBC.
• To compare the predictive accuracy of GPS, modified GPS (mGPS), and high-sensitivity mGPS (hs-mGPS).
• To evaluate the utility of these scores in stratifying risk for clinical decision-making.

Main Methods:

• A multicenter, retrospective cohort study of 504 decompensated PBC patients.
• Baseline C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), and albumin (ALB) levels were used to calculate GPS, mGPS, and hs-mGPS.
• Recompensation was defined by biochemical response, resolution of decompensation, and stable liver function per Baveno VII criteria.

Main Results:

• Higher GPS, mGPS, and hs-mGPS scores were significantly associated with lower 5-year recompensation rates (P < 0.0001).
• GPS, mGPS, and hs-mGPS were independent predictors of recompensation in Cox regression analysis.
• GPS demonstrated the highest predictive performance (AUC: 0.888) compared to mGPS (AUC: 0.795) and hs-mGPS (AUC: 0.871).

Conclusions:

• The GPS and its variants are reliable tools for predicting recompensation in decompensated PBC.
• GPS exhibits superior accuracy in predicting recompensation compared to its variants.
• These prognostic scores can aid in risk stratification and guide early intervention strategies for PBC patients.