Trajectory of Serum Bilirubin Predicts Spontaneous Recovery in a Real-World Cohort of Patients With Alcoholic Hepatitis

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dc.contributor.authorParker, Richard
dc.contributor.authorCabezas, Joaquin
dc.contributor.authorAltamirano, Jose
dc.contributor.authorArab, Juan Pablo
dc.contributor.authorVentura-Cots, Meritxell
dc.contributor.authorSinha, Ashish
dc.contributor.authorDhanda, Ashwin
dc.contributor.authorArrese, Marco
dc.contributor.authorMcCune, C. Anne
dc.contributor.authorRowe, Ian A.
dc.contributor.authorSchnabl, Bernd
dc.contributor.authorMathurin, Phillipe
dc.contributor.authorShawcross, Debbie
dc.contributor.authorAbraldes, Juan G.
dc.contributor.authorLucey, Michael R.
dc.contributor.authorGarcia-Tsao, Guadalupe
dc.contributor.authorVerna, Elizabeth
dc.contributor.authorBrown, Robert S., Jr.
dc.contributor.authorBosques-Padilla, Francisco
dc.contributor.authorVargas, Victor
dc.contributor.authorLouvet, Alexandre
dc.contributor.authorHolt, Andrew P.
dc.contributor.authorBataller, Ramon
dc.date.accessioned2025-01-20T22:00:43Z
dc.date.available2025-01-20T22:00:43Z
dc.date.issued2022
dc.description.abstractBACKGROUND AND AIMS: Alcoholic hepatitis (AH) is a severe condition with poor short-term prognosis. Specific treatment with corticosteroids slightly improves short-term survival but is associated with infection and is not used in many centers. A reliable method to identify patients who will recover spontaneously will minimise the numbers of patients who experience side effects of available treatments.
dc.description.abstractMETHODS: We analysed the trajectory of serum bilirubin concentration over the course of hospital ad missions in patients with AH to predict spontaneous survival and the need for treatment.
dc.description.abstractRESULTS: data from 426 patients were analysed. Based on bilirubin trajectory, patients were categorized into three groups: 'fast fallers' (bilirubin <0.8 x admission value at day 7), 'static' (bilirubin of >0.9 - <1.2 x admission value) and 'rapid risers' (bilirubin of >= 1.2 x admission bilirubin). Fast fallers had significantly better 90-day survival compared to other groups (log rank p < .001), and showed no benefit of corticosteroid therapy (OR for survival at 28 days of treatment, 0.94, 95% CI 0.06 - 8.41). These findings remained even amongst patients with severe disease based on initial DF, GAHS or MELD scores.
dc.description.abstractCONCLUSIONS: We present an intuitive method of classifying patients with AH based on the trajectory of bilirubin over the first week of admission. It is complimentary to existing scores that identify candidates for corticosteroid treatment or assess response to treatment. This method identifies a group of patients with AH who recover spontaneously and can avoid corticosteroid therapy.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.cgh.2021.01.042
dc.identifier.eissn1542-7714
dc.identifier.issn1542-3565
dc.identifier.urihttps://doi.org/10.1016/j.cgh.2021.01.042
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93741
dc.identifier.wosidWOS:000748508800024
dc.issue.numero2
dc.language.isoen
dc.pagina.finalE297
dc.pagina.inicioE289
dc.revistaClinical gastroenterology and hepatology
dc.rightsacceso restringido
dc.subjectAlcoholic Hepatitis
dc.subjectOutcomes
dc.subjectCorticosteroid
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleTrajectory of Serum Bilirubin Predicts Spontaneous Recovery in a Real-World Cohort of Patients With Alcoholic Hepatitis
dc.typeartículo
dc.volumen20
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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