OBJECTIVES: Prognostic stratification of patients with alcoholic hepatitis (AH) may improve the clinical management and facilitate clinical trials. We aimed at developing a scoring system capable of providing prognostic stratification of patients with AH. METHODS: Patients with biopsy-proven AH were prospectively included between 2000 and 2006. The biochemical, clinical, portal hemodynamic and histological parameters were evaluated. A Cox regression model was used for univariate and multivariate analyses. A predictive score was built using variables obtained at admission identified in the multivariate analysis. The resulting score was validated in an independent prospective cohort. RESULTS: In total, 103 patients with biopsy-proven AH were included in the study cohort. Age, serum bilirubin, serum creatinine, and international normalized ratio (INR) independently predicted 90-day mortality. We generated the Age, serum Bilirubin, INR, and serum Creatinine (ABIC) score: (age x 0.1) + (serum bilirubin x 0.08) + (serum creatinine x 0.3) + (INR x 0.8). The area under the curve (AUC) was 0.82. Using the Kaplan-Meier analysis with the cutoff values of 6.71 and 9.0, we identified patients with low, intermediate, and high risk of death at 90 days (100%, 70%, and 25% of survival rate, respectively). Using the same cutoff values, the ABIC score also stratified patients according to their risk of death at 1 yr. These results were validated by a confirmatory cohort (N = 80). CONCLUSIONS: The ABIC score is a new tool that allows the stratification of risk of death in patients with AH at 90 days and 1 yr. This score can help improve the management of these patients and also help to perform clinical trials.
OBJECTIVES: Prognostic stratification of patients with alcoholic hepatitis (AH) may improve the clinical management and facilitate clinical trials. We aimed at developing a scoring system capable of providing prognostic stratification of patients with AH. METHODS:Patients with biopsy-proven AH were prospectively included between 2000 and 2006. The biochemical, clinical, portal hemodynamic and histological parameters were evaluated. A Cox regression model was used for univariate and multivariate analyses. A predictive score was built using variables obtained at admission identified in the multivariate analysis. The resulting score was validated in an independent prospective cohort. RESULTS: In total, 103 patients with biopsy-proven AH were included in the study cohort. Age, serum bilirubin, serum creatinine, and international normalized ratio (INR) independently predicted 90-day mortality. We generated the Age, serum Bilirubin, INR, and serum Creatinine (ABIC) score: (age x 0.1) + (serum bilirubin x 0.08) + (serum creatinine x 0.3) + (INR x 0.8). The area under the curve (AUC) was 0.82. Using the Kaplan-Meier analysis with the cutoff values of 6.71 and 9.0, we identified patients with low, intermediate, and high risk of death at 90 days (100%, 70%, and 25% of survival rate, respectively). Using the same cutoff values, the ABIC score also stratified patients according to their risk of death at 1 yr. These results were validated by a confirmatory cohort (N = 80). CONCLUSIONS: The ABIC score is a new tool that allows the stratification of risk of death in patients with AH at 90 days and 1 yr. This score can help improve the management of these patients and also help to perform clinical trials.
Authors: Patricia P Bloom; Amirkasra Mojtahed; Emily D Bethea; Sally A Knooihuizen; Jin Choi; Jules L Dienstag; Raymond T Chung; Chin Hur Journal: Dig Dis Sci Date: 2019-07-30 Impact factor: 3.199
Authors: Katharina Brandl; Phillipp Hartmann; Lily J Jih; Donald P Pizzo; Josepmaria Argemi; Meritxell Ventura-Cots; Sally Coulter; Christopher Liddle; Lei Ling; Stephen J Rossi; Alex M DePaoli; Rohit Loomba; Wajahat Z Mehal; Derrick E Fouts; Michael R Lucey; Francisco Bosques-Padilla; Philippe Mathurin; Alexander Louvet; Guadalupe Garcia-Tsao; Elizabeth C Verna; Juan G Abraldes; Robert S Brown; Victor Vargas; Jose Altamirano; Juan Caballería; Debbie Shawcross; Peter Stärkel; Samuel B Ho; Ramon Bataller; Bernd Schnabl Journal: J Hepatol Date: 2018-04-12 Impact factor: 25.083
Authors: Javier Michelena; José Altamirano; Juan G Abraldes; Silvia Affò; Oriol Morales-Ibanez; Pau Sancho-Bru; Marlene Dominguez; Juan Carlos García-Pagán; Javier Fernández; Vicente Arroyo; Pere Ginès; Alexandre Louvet; Philippe Mathurin; Wajahat Z Mehal; Juan Caballería; Ramón Bataller Journal: Hepatology Date: 2015-04-13 Impact factor: 17.425