Acute Alcoholic Hepatitis: Natural History and Predictors of Mortality Using a Multicenter Prospective Study
dc.contributor.author | Lourens, Spencer | |
dc.contributor.author | Sunjaya, Dharma B. | |
dc.contributor.author | Singal, Ashwani | |
dc.contributor.author | Liangpunsakul, Suthat | |
dc.contributor.author | Puri, Puneet | |
dc.contributor.author | Sanyal, Arun | |
dc.contributor.author | Ren, Xiaowei | |
dc.contributor.author | Gores, Gregory J. | |
dc.contributor.author | Radaeva, Svetlana | |
dc.contributor.author | Chalasani, Naga | |
dc.contributor.author | Crabb, David W. | |
dc.contributor.author | Katz, Barry | |
dc.contributor.author | Kamath, Patrick S. | |
dc.contributor.author | Shah, Vijay H. | |
dc.contributor.department | Biostatistics, School of Public Health | en_US |
dc.date.accessioned | 2019-04-30T17:08:28Z | |
dc.date.available | 2019-04-30T17:08:28Z | |
dc.date.issued | 2017-04-28 | |
dc.description.abstract | Objective: To examine the natural history of acute alcoholic hepatitis (AH) and identify predictors of mortality for AH using data from a prospective multicenter observational study. Participants and Methods: We analyzed data from 164 patients with AH and 131 heavy-drinking controls with no liver disease. Participants underwent clinical/laboratory assessment at baseline and 6 and 12 months after enrollment. Multivariable analyses were conducted to identify variables associated with mortality and examine the association between coffee drinking and risk of AH. Results: Thirty-six patients with AH died during follow-up, with estimated 30-day, 90-day, 180-day, and 1-year survival of 0.91 (95% CI, 0.87-0.96), 0.85 (95% CI, 0.80-0.91), 0.80 (95% CI, 0.74-0.87), and 0.75 (95% CI, 0.68-0.83), respectively. In the multivariable analysis, higher serum bilirubin level (hazard ratio [HR]=1.059; 95% CI, 1.022-1.089), lower hemoglobin level (HR=1.263; 95% CI, 1.012-1.575), and lower platelet count (HR=1.006; 95% CI, 1.001-1.012) were independently associated with mortality in AH. Compared with controls, fewer patients with AH regularly consumed coffee (20% vs 44%; P<.001), and this association between regular coffee drinking and lower risk of AH persisted after controlling for relevant covariates (odds ratio=0.26; 95% CI, 0.15-0.46). Time-dependent receiver operating characteristic curve analysis revealed that Model for End-Stage Liver Disease; Maddrey Discriminant Function; age, serum bilirubin, international normalized ratio, and serum creatinine; and Child-Pugh scores all provided similar discrimination performance at 30 days (area under the curve=0.73-0.77). Conclusion: Alcoholic hepatitis remains highly fatal, with 1-year mortality of 25%. Regular coffee consumption was associated with lower risk of AH in heavy drinkers. | en_US |
dc.identifier.citation | Lourens, S., Sunjaya, D. B., Singal, A., Liangpunsakul, S., Puri, P., Sanyal, A., … TREAT Consortium (2017). Acute Alcoholic Hepatitis: Natural History and Predictors of Mortality Using a Multicenter Prospective Study. Mayo Clinic proceedings. Innovations, quality & outcomes, 1(1), 37–48. doi:10.1016/j.mayocpiqo.2017.04.004 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/19019 | |
dc.language.iso | en_US | en_US |
dc.publisher | Elsevier | en_US |
dc.relation.isversionof | 10.1016/j.mayocpiqo.2017.04.004 | en_US |
dc.relation.journal | Mayo Clinic proceedings. Innovations, quality & outcomes | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.source | PMC | en_US |
dc.subject | ABIC | en_US |
dc.subject | Serum bilirubin | en_US |
dc.subject | Akaike Information Criterion | en_US |
dc.subject | Model for End-Stage Liver Disease | en_US |
dc.subject | Translational Research and Evolving Alcoholic Hepatitis Treatment | en_US |
dc.title | Acute Alcoholic Hepatitis: Natural History and Predictors of Mortality Using a Multicenter Prospective Study | en_US |
dc.type | Article | en_US |