Niharika Samala1, Samer Gawrieh1, Qing Tang2, Spencer G Lourens2, Vijay H Shah3, Arun J Sanyal4, Suthat Liangpunsakul1,5,6, Naga Chalasani1. 1. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. 2. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana. 3. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota. 4. Division of Gastroenterology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. 5. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana. 6. Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana.
Abstract
INTRODUCTION & AIM: Much is known about alcoholic hepatitis (AH) that is severe enough to require hospitalization. The characteristics of individuals with alcoholic hepatitis presenting with mild to moderate severity are not well understood. In this study we investigated the risk factors, characteristics, and outcomes of mild to moderate AH. METHODS: Two hundred and fifty five Individuals with AH enrolled into a multicenter, prospective, observational study between 12/2014 and 4/2018 were included. Participants were seen at enrollment, 6 months, and 12 months. Mild to moderate AH (M-AH) was defined as MELD ≤ 20 at presentation whereas severe AH as MELD ≥ 21. RESULTS: One hundred individuals had M-AH whereas 155 had severe AH. Individuals with M-AH were older (49 vs 44 years, p=0.01), had lower BMI (27 vs 31 kg/m2, p=0.0007) and more likely to be male (68% vs 55%, p=0.046) compared to severe AH group. A higher proportion in M-AH group consumed coffee in the last 5 years compared to the severe AH (29% vs 18%, p=0.03), and fewer had PNPLA3 risk allele G (p=0.019) compared to the severe AH group. Average drinks per drinking day (12.9 vs 10.7, p=0.13) and total number of drinks in last 30 day period (331 vs 280, p=0.14) were not different between two groups. Compared to severe AH, patients with M-AH had significantly lower mortality at 30 days (2% vs. 13.6%), 90 days (3% vs. 22.6%), and 12 months (10.4% vs. 31.4%) (p <0.001 for all). CONCLUSIONS: Individuals with mild to moderate AH were older, less obese, drank coffee more often and carried more favorable PNPLA3 genotype compared to severe AH, despite similar alcohol consumption. Mild to moderate AH had substantial mortality with one in ten dying by 12 months. (Word Count 286).
INTRODUCTION & AIM: Much is known about alcoholic hepatitis (AH) that is severe enough to require hospitalization. The characteristics of individuals with alcoholic hepatitis presenting with mild to moderate severity are not well understood. In this study we investigated the risk factors, characteristics, and outcomes of mild to moderate AH. METHODS: Two hundred and fifty five Individuals with AH enrolled into a multicenter, prospective, observational study between 12/2014 and 4/2018 were included. Participants were seen at enrollment, 6 months, and 12 months. Mild to moderate AH (M-AH) was defined as MELD ≤ 20 at presentation whereas severe AH as MELD ≥ 21. RESULTS: One hundred individuals had M-AH whereas 155 had severe AH. Individuals with M-AH were older (49 vs 44 years, p=0.01), had lower BMI (27 vs 31 kg/m2, p=0.0007) and more likely to be male (68% vs 55%, p=0.046) compared to severe AH group. A higher proportion in M-AH group consumed coffee in the last 5 years compared to the severe AH (29% vs 18%, p=0.03), and fewer had PNPLA3 risk allele G (p=0.019) compared to the severe AH group. Average drinks per drinking day (12.9 vs 10.7, p=0.13) and total number of drinks in last 30 day period (331 vs 280, p=0.14) were not different between two groups. Compared to severe AH, patients with M-AH had significantly lower mortality at 30 days (2% vs. 13.6%), 90 days (3% vs. 22.6%), and 12 months (10.4% vs. 31.4%) (p <0.001 for all). CONCLUSIONS: Individuals with mild to moderate AH were older, less obese, drank coffee more often and carried more favorable PNPLA3 genotype compared to severe AH, despite similar alcohol consumption. Mild to moderate AH had substantial mortality with one in ten dying by 12 months. (Word Count 286).
Authors: Jeffrey W Molloy; Christopher J Calcagno; Christopher D Williams; Frances J Jones; Dawn M Torres; Stephen A Harrison Journal: Hepatology Date: 2011-12-22 Impact factor: 17.425
Authors: Winston Dunn; Laith H Jamil; Larry S Brown; Russell H Wiesner; W Ray Kim; K V Narayanan Menon; Michael Malinchoc; Patrick S Kamath; Vijay Shah Journal: Hepatology Date: 2005-02 Impact factor: 17.425
Authors: Suthat Liangpunsakul; James J Beaudoin; Vijay H Shah; Puneet Puri; Arun J Sanyal; Patrick S Kamath; Spencer G Lourens; Qing Tang; Barry P Katz; David W Crabb; Naga P Chalasani Journal: Hepatol Commun Date: 2017-11-11