Coexisting inflammatory bowel disease in primary sclerosing cholangitis is associated with higher colorectal cancer and transplant risk
Bibliographic record
Abstract
BACKGROUND: Primary sclerosing cholangitis (PSC) is often intertwined with inflammatory bowel disease (IBD), presenting a complex clinical scenario. The coexistence of IBD-PSC complicates disease management and progression, potentially exacerbating outcomes. OBJECTIVES: This study aims to evaluate the specific impact of IBD in patients with PSC, focusing on both liver-related and IBD-specific clinical outcomes. METHODS: This retrospective study, utilizing the TriNetX database, performed propensity score matching to compare clinical outcomes between IBD-PSC and PSC-only patients, as well as IBD-PSC and IBD-only patients. Diagnoses were identified based on International Classification of Diseases-10 coding. RESULTS: The study analyzed 1941 patients with IBD-PSC, 234,081 with IBD alone, and 628 with PSC alone. Patients with IBD-PSC had significantly higher mortality compared to IBD alone (16.0% vs. 7.5%; hazard ratio [HR]: 2.256, 95% confidence interval [CI]: 1.853-2.747, p < 0.001), as well as increased rates of hospitalization (32.8% vs. 14.5%; HR: 2.641, 95% CI: 2.213-3.152, p < 0.001) and intensive care unit admission (18.7% vs. 5.8%; HR: 3.691, 95% CI: 2.954-4.612, p < 0.001). Colorectal cancer was also more frequent in the IBD-PSC group (2.4% vs. 0.7%; HR: 3.370, 95% CI: 1.846-6.152, p < 0.001). When compared to PSC alone, IBD-PSC patients had a higher rate of liver transplantation (12.3% vs. 8.0%; HR: 1.492, 95% CI: 1.012-2.198, p = 0.042), whereas rates of hepatocellular carcinoma and cholangiocarcinoma were similar between groups. CONCLUSIONS: Patients with coexisting IBD and PSC experience greater clinical severity, including higher mortality, hospitalization, and colorectal cancer risk. They also have increased liver transplant incidence. Further research is needed to explore underlying mechanisms and improve management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".