{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T20:42:08Z","timestamp":1770324128388,"version":"3.49.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":5936,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,6]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>The Child\u2013Pugh classification is a simple, convenient prognostic measure in patients with liver cirrhosis. We investigated the relative role of the Child\u2013Pugh classification and the Mayo model in the assessment of survival in patients with primary sclerosing cholangitis (PSC). Of the 173 patients described in the original Mayo PSC natural history model, 147 patients had sufficient information in the medical record to allow computation of the Child\u2013Pugh score. We used our most recent modification of the Mayo model to compute the risk score, based on patient's age, serum levels of bilirubin, albumin, and aspartate aminotransferase and history of variceal bleeding. Using the risk score (R), patients were divided into the low\u2013 (R &lt; 0), intermediate\u2013 (0 \u2264 R &lt; 2), and high\u2013risk (R \u2265 2) groups. Kaplan\u2013Meier estimates and proportional hazards analysis were used to evaluate the two prognostic models. Although there was a statistically significant correlation between the Child\u2013Pugh and Mayo risk scores, two\u2013thirds of the patients had a Child\u2013Pugh score of 5 or 6 and a relatively wide range of risk scores (-1.1\u20134.3). The probability of survival for 7 years in patients in the low\u2013, intermediate\u2013, and high\u2013risk groups was 92%, 74%, and 40% for Child\u2013Pugh class A (n = 96) and 100%, 62%, and 28% for Child\u2013Pugh class B patients (n = 44), respectively. There were only a small number (n = 7) of Child\u2013Pugh class C patients. In our age\u2013adjusted multivariate analysis, each unit increase in the Mayo risk score was associated with a 2.5\u2013fold increase in the risk of death (95% confidence interval: 1.8\u20133.4, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .01), whereas Child\u2013Pugh classification had no significant impact on survival (Child\u2013Pugh B vs. A: risk ratio = 1.1 [95% confidence interval: 0.6\u20132.0]; Child\u2013Pugh C versus A: risk ratio = 0.6 [95% confidence interval: 0.2\u20131.8]). In contrast to the Child\u2013Pugh classification, which was developed for advanced liver cirrhosis, the Mayo model provides valid survival information, particularly in patients early in the course of PSC.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510290607","type":"journal-article","created":{"date-parts":[[2004,7,28]],"date-time":"2004-07-28T07:25:40Z","timestamp":1090999540000},"page":"1643-1648","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":109,"title":["The Relative Role of the Child\u2013Pugh Classification and the Mayo Natural History Model in the Assessment of Survival in Patients With Primary Sclerosing Cholangitis"],"prefix":"10.1097","volume":"29","author":[{"given":"Ray W.","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Poterucha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell H.","family":"Wiesner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas F.","family":"LaRusso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith D.","family":"Lindor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Petz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry M.","family":"Therneau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Malinchoc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolland E.","family":"Dickson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"BIB1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1002\/hep.1840100406","volume":"10","author":"Wiesner","year":"1989","journal-title":"Hepatology"},{"key":"BIB2","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1016\/0016-5085(91)90673-9","volume":"100","author":"Farrant","year":"1991","journal-title":"Gastroenterology"},{"key":"BIB3","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1016\/0016-5085(92)91449-E","volume":"103","author":"Dickson","year":"1992","journal-title":"Gastroenterology"},{"key":"BIB4","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1136\/gut.38.4.610","volume":"38","author":"Broome","year":"1996","journal-title":"Gut"},{"key":"BIB5","first-page":"a1274","volume":"114","author":"Kim","year":"1998","journal-title":"Gastroenterology"},{"key":"BIB6","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1056\/NEJM199703063361003","volume":"336","author":"Lindor","year":"1997","journal-title":"N Engl J Med"},{"key":"BIB7","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/S0039-6060(05)80078-9","volume":"117","author":"Farges","year":"1995","journal-title":"2 Surgery"},{"key":"BIB8","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1097\/00000658-199803000-00014","volume":"227","author":"Ahrendt","year":"1998","journal-title":"3 Ann Surg"},{"key":"BIB9","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1002\/hep.510250501","volume":"25","author":"Shetty","year":"1997","journal-title":"Hepatology"},{"key":"BIB10","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1056\/NEJM198404053101407","volume":"310","author":"LaRusso","year":"1984","journal-title":"14 N Engl J Med"},{"key":"BIB11","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","volume":"60","author":"Pugh","year":"1973","journal-title":"8 Br J Surg"},{"key":"BIB12","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1002\/lt.500030613","volume":"3","author":"Lucey","year":"1997","journal-title":"Liver Transplant Surg"},{"key":"BIB13","first-page":"628","volume-title":"The liver and portal hypertension","author":"Child","unstructured":"Surgery and portal hypertension. 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