cliot (version 1.0.0)

revised_psc_risk_score: Revised Natural History Model for Primary Sclerosing Cholangitis (PSC)

Description

Calculates the Revised Natural History Model (Mayo PSC Risk Score) for patients with Primary Sclerosing Cholangitis. This prognostic score estimates survival (time to death or liver transplantation) based on age, bilirubin, albumin, AST, and history of variceal bleeding. It updates the original Mayo model by removing the need for liver biopsy (histologic stage).

Usage

revised_psc_risk_score(age, bilirubin_mg_dl, albumin_g_dl, ast_u_l,
                       history_variceal_bleeding)

Value

A list containing:

PSC_Risk_Score

The calculated risk score (R).

Arguments

age

Numeric. Patient age in years.

bilirubin_mg_dl

Numeric. Total serum bilirubin in mg/dL.

albumin_g_dl

Numeric. Serum albumin in g/dL.

ast_u_l

Numeric. Aspartate aminotransferase (AST) level in U/L.

history_variceal_bleeding

Numeric (0 or 1). History of variceal bleeding. (1 = Yes, 0 = No).

Details

The score is calculated using the formula: $$R = 0.03 \times Age + 0.54 \times \ln(Bilirubin) + 0.54 \times \ln(AST) + 1.24 \times VaricealBleeding - 0.84 \times Albumin$$ Higher scores indicate a worse prognosis (higher risk of death or need for transplant).

References

Kim WR, Therneau TM, Wiesner RH, et al. A revised natural history model for primary sclerosing cholangitis. Mayo Clin Proc. 2000;75(7):688-694. doi:10.4065/75.7.688

Examples

# Example 1: High Risk
# 50yo, Bili 5.0, Alb 2.5, AST 150, Bleeding Hx
revised_psc_risk_score(50, 5.0, 2.5, 150, 1)

# Example 2: Low Risk
# 30yo, Bili 0.8, Alb 4.0, AST 30, No Bleeding
revised_psc_risk_score(30, 0.8, 4.0, 30, 0)