Clinical characteristics and prognosis of hospitalized patients with moderate alcohol-associated hepatitis

dc.contributor.authorGaurnizo-Ortiz, Maria
dc.contributor.authorNephew, Lauren D.
dc.contributor.authorVilar-Gomez, Eduardo
dc.contributor.authorKettler, Carla D.
dc.contributor.authorSlaven, James E.
dc.contributor.authorGhabril, Marwan S.
dc.contributor.authorDesai, Archita P.
dc.contributor.authorOrman, Eric S.
dc.contributor.authorChalasani, Naga
dc.contributor.authorGawrieh, Samer
dc.contributor.authorPatidar, Kavish R.
dc.date.accessioned2025-06-02T15:26:12Z
dc.date.available2025-06-02T15:26:12Z
dc.date.issued2024
dc.description.abstractBackground and Aims Little is known about the clinical characteristics and prognosis of hospitalized patients with moderate alcohol-associated hepatitis (mAH) as compared to severe alcohol-associated hepatitis (sAH). Therefore, we aimed to describe the clinical characteristics and risk factors associated with mortality in hospitalized mAH patients. Methods Patients hospitalized with alcohol-associated hepatitis (AH) from 1 January 2010 to 31 December 2020 at a large US healthcare system [11 hospitals, one liver transplant centre] were retrospectively analysed for outcomes. Primary outcome was 90-day mortality. AH and mAH were defined according to NIAAA Alcoholic Hepatitis Consortia and Model for End-stage Liver Disease Score ≤ 20 respectively. Multivariable Cox regression analysis was performed to identify independent risk factors associated with 90-day mortality. Results 1504 AH patients were hospitalized during the study period, of whom 39% (n = 590) had mAH. Compared to sAH patients, mAH patients were older (50 vs. 48 years, p < 0.001) and less likely to have underlying cirrhosis (74% vs. 83%, p < 0.001). There were no differences between the two groups for median alcohol intake g/day (mAH 140.0 vs. sAH 112.0, p = 0.071). The cumulative proportion surviving at 90 days was 88% in mAH versus 62% in sAH (p < 0.001). On multivariable analysis, older age [HR 1.03 (95% CI 1.00–1.06), p = 0.020], corticosteroid use [HR 1.80 (95% CI 1.06–3.06), p = 0.030] and acute kidney injury (AKI) [HR 2.43 (95% CI 1.33–4.47), p = 0.004] were independently associated with 90-day mortality. Conclusions mAH carries a 12% mortality rate at 90 days. Age, AKI and corticosteroid use were associated with an increased risk for 90-day mortality. Avoidance of corticosteroids and strategies to reduce the risk of AKI could improve outcomes in mAH patients.
dc.identifier.citationGaurnizo-Ortiz, M., Nephew, L. D., Vilar-Gomez, E., Kettler, C. D., Slaven, J. E., Ghabril, M. S., Desai, A. P., Orman, E. S., Chalasani, N., Gawrieh, S., & Patidar, K. R. (2024). Clinical characteristics and prognosis of hospitalized patients with moderate alcohol-associated hepatitis. Liver International, 44(1), 241–249. https://doi.org/10.1111/liv.15771
dc.identifier.urihttps://hdl.handle.net/1805/48508
dc.language.isoen_US
dc.publisherWiley Online Library
dc.relation.isversionof10.1111/liv.15771
dc.subjectAlcohol-associated hepatitis
dc.titleClinical characteristics and prognosis of hospitalized patients with moderate alcohol-associated hepatitis
dc.typeArticle
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