New prognostic model for hospitalized patients with alcoholic cirrhosis and Maddrey's discriminant function <32.
Hepatol Int
; 18(2): 500-508, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-37831433
ABSTRACT
BACKGROUND & AIMS:
Few studies have investigated the prognosis of patients with non-severe alcoholic hepatitis (Non-SAH). The study aimed to develop a new prognostic model for patients with especially Non-SAH.METHODS:
We extracted 316 hospitalized patients with alcoholic cirrhosis without severe alcoholic hepatitis, defined as Maddrey's discriminant function score lower than 32, from the retrospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort to develop a new prognostic model (training set), and validated it in 419 patients from the prospective KACLiF cohort (validation set). Prognostic factors for death and liver transplantation were analyzed to construct a prognostic model.RESULTS:
Twenty-one and 24 patients died within 6 months in both sets, respectively. In the training set, the highest area under the curve (AUC) of conventional prognostic models was 0.765, 0.732, and 0.684 for 1-, 3-, and 6-month mortality, respectively. Refractory ascites, vasopressor use, and hyponatremia were independently associated with mortality of cirrhotic patients with Non-SAH. The new model consisted of four variables past deterioration, neutrophil proportion > 70%, Na < 128 mmol/L, and vasopressor use. It showed the highest accuracy for short-term mortality in the training and validation sets (0.803 and 0.786; 0.797 and 0.776; and 0.789 and 0.721 for 1-, 3-, and 6-month mortality, respectively).CONCLUSION:
There is a group of patients with high risk among those classified as Non-SAH. The new model will help stratifying cirrhotic patients with Non-SAH more accurately in terms of prognosis. The patients with high Non-SAH score need to monitor closely and might be considered for preemptive liver transplantation. TRIAL REGESTRATION ClinicalTrials.gov identifier NCT02650011.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acute-On-Chronic Liver Failure
/
Hepatitis, Alcoholic
Limits:
Humans
Language:
En
Journal:
Hepatol Int
Year:
2024
Document type:
Article