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Design and validation of an early scoring system for predicting early outcomes of type III biliary atresia after Kasai’s operation

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Abstract

Background/purpose

The purpose of this study was to determine reliable predictors of outcome of biliary atresia (BA) after Kasai’s operation.

Patients and methods

This study included two consecutive stages of infants with biliary atresia. First stage, 200 BA cases who underwent Kasai’s operation at our institution between May 2006 and May 2010 were retrospectively reviewed. In the first stage, we wanted to calculate a clinical scoring system by logistic regression. For cut-off determination, receiver operating characteristic (ROC) analysis was employed. Second stage (validation of scoring system), we used our scoring system to prospectively predict the outcomes of patients underwent a Kasai operation from inspecting the accuracy of our system.

Results

Early cholangitis, age at operation, JC time, post-operative TB, DB, AST, ALT and surgical method entered into our scoring system. The most reliable cut-offs determined by ROC analysis were 7.71 (sensitivity: 86.0 %, specificity: 98.0 %). We used our scoring system to predict the prognosis of the 15 BA patients and found that 13 of 15 patients were correctly predicted at the cut-off value of 7.71.

Conclusion

Our scoring system is considered to be a reliable and useful predictor of the prognosis of biliary atresia.

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Acknowledgments

We thank those patients who supported our study and authors who provided us with the full text.

Conflict of interest

None declared.

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Author notes

    Authors and Affiliations

    1. Department of Pediatric Surgery, Capital Institute of Pediatrics-Peking University Teaching Hospital, Yabao Road 2#, Chaoyang, Beijing, 100021, People’s Republic of China

      Chen Zhen, Qiao Guoliang, Ma Lishuang, Zhang Zhen, Wang Chen, Zhang Jun, Liu Shuli, Guan Kaoping, Liu Chao, Yang Xuan & Li Long

    2. Medical Department, Peking University, Beijing, 100000, People’s Republic of China

      Chen Zhen

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    1. Chen Zhen
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    Correspondence to Li Long.

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    C. Zhen, Q. Guoliang and M. Lishuang contributed equally to this work.

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    Zhen, C., Guoliang, Q., Lishuang, M. et al. Design and validation of an early scoring system for predicting early outcomes of type III biliary atresia after Kasai’s operation. Pediatr Surg Int 31, 535–542 (2015). https://doi.org/10.1007/s00383-015-3710-3

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    • DOI: https://doi.org/10.1007/s00383-015-3710-3

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