Alcoholic hepatitis: Diagnosis and prognosis

Drinane, Mary; Shah, Vijay H.

doi:10.1002/cld.164

Cited by 11 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We collected the following data from electronic medical records: age, sex, etiology of liver diseases, ascites, hepatic encephalopathy (HE), history of upper gastrointestinal bleeding (UGIB), endoscopic findings, red blood cells (RBC), hemoglobin (Hb), white blood cells (WBC), platelets (PLT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamine transferase (GGT), international normalized ratio (INR), albumin (ALB), total bilirubin (TBIL), blood urea nitrogen (BUN), and creatinine (Cr). Additionally, we calculated the model for end-stage liver disease (MELD) [23], APRI [24], AAR [25], FIB-4 [26], FI [27], King's score [28], Lok index [29], ABIC [17], ALBI [20], and PALBI [21]. PALBI was categorized as: PALBI 1 (score ≤ 2.53), PALBI 2 (score > 2.53 and ≤2.09), and PALBI 3 (score > 2.09) [16].…”

Section: Data Collectionmentioning

confidence: 99%

“…Recent studies have showed that non-invasive scores, such as the model for end-stage liver disease (MELD), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), AST to platelet ratio index (APRI), fibrosis-4index (FIB-4), fibrosis index (FI), and King's score, are simple, non-invasive methods which could be used in the prediction of EV in cirrhotic patients [9][10][11][12][13][14][15][16]. Other predictive scores: age-bilirubin-INR-creatinine (ABIC) score, Glasgow alcoholic hepatitis score (GAHS), and Lille model, are useful in predicting the outcome of patients with alcoholic hepatitis [17]. The ABIC score was developed to categorize patients with AH into high-, moderate-, and low-risk groups based on the risk of death at 90 days and 1 year [18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Value of Non-invasive Scoring Systems in the Prediction of Esophageal Varices in Patients with Liver Cirrhosis—Single Center Experience

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Upper endoscopy is considered the gold standard for screening and diagnosis of esophageal varices (EV). Non-invasive methods for predicting EV have become a research hotspot in recent years. The aim of this study was to assess the role of non-invasive scores in predicting the presence of EV in patients with liver cirrhosis, and to determine the value of these scores in predicting the outcome of patients with cirrhosis presenting with acute variceal bleeding. Materials and Methods: A total of 386 patients with liver cirrhosis were included. The model for end-stage liver disease (MELD), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), AST to platelet ratio index (APRI), fibrosis-4-index (FIB-4), fibrosis index (FI), King’s Score, albumin-bilirubin (ALBI) score, and platelet-albumin-bilirubin (PALBI) score were calculated. The discriminatory capacities of the examined scores in predicting the presence of esophageal varices were tested using receiver operating characteristic (ROC) curves. Results: The ROC curve analysis showed (area under the curve) AUC values of ALBI and PALBI of 0.603, and 0.606, respectively, for the prediction of EV. APRI, MELD, PALBI, King’s, FIB-4, and ALBI scores showed statistically significant correlation with EV bleeding (p < 0.05). AUC of APRI and MELD for predicting EV bleeding were 0.662 and 0.637, respectively. The AUC value of MELD in short-term mortality was 0.761. Conclusions: ALBI and PALBI scores had modest diagnostic accuracy of EVs in liver cirrhosis. APRI and MELD can be used as a reference index for the EV bleeding, and MELD score is best associated with short-term outcome in cirrhotic patients.

show abstract

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Non-invasive Scoring Systems in the Prediction of Esophageal Varices in Patients with Liver Cirrhosis—Single Center Experience

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Patients with AH are prone to portal hypertension and can therefore have an AVB even without established cirrhosis, due to profound inflammatory infiltrates within the hepatic sinusoids. Patients with AH have a very high short-term mortality 29 and any bleeding complication will inevitably confer additional prognostic burden. The incidence, prevalence, and natural history of AVB in AH is not well described in this particular setting.…”

Section: Acute Variceal Bleed In Patients With Severe Alcoholic Hepatmentioning

confidence: 99%

The role of pre-emptive Transjugular Intrahepatic Portosystemic Shunt in acute variceal bleeding: a literature review

Manning

Elzubeir

Alam

2021

Therapeutic Advances in Chronic Disease

View full text Add to dashboard Cite

The development of portal hypertension has serious implications in the natural history of liver cirrhosis, leading to complications such as ascites, hepatic encephalopathy and variceal bleeding. The management of acute variceal bleeding has improved in the last two decades, but despite the advances in endoscopic methods the overall prognosis remains poor, particularly within a subgroup of patients with more advanced disease. The role of Transjugular Intrahepatic Portosystemic Shunt (TIPSS) is a well-established method of achieving haemostasis by immediate portal decompression; however, its use in an emergency setting as a rescue strategy is still associated with high mortality. It has been shown that ‘early’ use of TIPSS as a pre-emptive strategy in a patient with acute variceal bleed in addition to the standard of care confers superior survival outcomes in a subgroup of patients at high risk of treatment failure and death. The purpose of this review is to appraise the literature around the indications, patient selection, utility, complications and economic considerations of pre-emptive TIPSS.

show abstract

“…The rationale for stratification of patients with MELD > 31 was based on the significantly higher probability of a 90-day mortality rate in patients with MELD > 31 compared with those below 31. 60 Other ongoing or recent novel human clinical trials tested the efficacy of G-CSF or IL-22. In a randomized pilot study, G-CSF administration improved liver functions and increased survival in patients with severe AH.…”

Section: Understanding Disease Pathology Informs Strategies For Drug mentioning

confidence: 99%

“…Most interventional clinical trials to date investigated patients with severe AH defined as MELD > 20 or DF > 32. 20,60 Some studies have limited enrollment in high MELD score ranges to exclude very sick patients (Maddrey > 90 or MELD > 36). Arguments have been made that due to the advanced stage and severe complications of AAH, patients may have entered an irreversible complexity of multiorgan failure with a high mortality that is no longer amenable to treatment.…”

Section: Patient Selection and Definition Of Alcoholic Hepatitis -Sevmentioning

confidence: 99%

Clinical Trial Design for Alcoholic Hepatitis

Szabó

2017

Semin Liver Dis

View full text Add to dashboard Cite

Alcoholic hepatitis (AH) is an acute and clinically distinct manifestation of alcoholic liver disease. While severe AH causes 30% or higher mortality in 3 months, treatment options are limited and ineffective. Recent advances on the understanding of the pathomechanisms of AH have identified numerous potential targets for new therapeutic interventions. Many of those targets are currently under preclinical testing and/or in human clinical trials for nonalcoholic steatohepatitis. Thus, the field of AH should be ready to launch new efforts and targeted clinical trials for this underserved patient population. There are remaining challenges in designing clinical trials in AH that include definition of the severity of disease, common data elements in clinical trial design, and selection of clinically meaningful endpoints. Future efforts and consensus meetings between regulatory agencies, academic and clinical experts, and industry will be instrumental to advance this emerging and greatly needed field of clinical investigations.

show abstract

Alcoholic hepatitis: Diagnosis and prognosis

Cited by 11 publications

References 16 publications

Diagnostic Value of Non-invasive Scoring Systems in the Prediction of Esophageal Varices in Patients with Liver Cirrhosis—Single Center Experience

Diagnostic Value of Non-invasive Scoring Systems in the Prediction of Esophageal Varices in Patients with Liver Cirrhosis—Single Center Experience

The role of pre-emptive Transjugular Intrahepatic Portosystemic Shunt in acute variceal bleeding: a literature review

Clinical Trial Design for Alcoholic Hepatitis

Contact Info

Product

Resources

About