Prognostic value of hepatic venous pressure gradient for in‐hospital mortality of patients with severe acute alcoholic hepatitis

Rincón, Diego; Iacono, Oreste Lo; Ripoll, Cristina; Gómez‐Camarero, Judith; Salcedo, Magdalena; Catalina, María Vega; Hernando, Ana; Clemente, G.; Matilla, A; Núñez, Óscar; Bañares, Rafael

doi:10.1111/j.1365-2036.2007.03258.x

Cited by 83 publications

(36 citation statements)

References 39 publications

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“…have signs of portal hypertension. This retrospective study focused on analyzing the predictive ability of indices that can be calculated with data usually available in the medical record, although recent studies have also examined the role of liver biopsy (24) (not available in our patients when the diagnosis was clear using clinical and laboratory criteria) and portal hypertension (25). This interesting question could not be explored in our sample as we do not have a liver hemodynamic unit in our hospital.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors associated with mortality in patients with severe alcoholic hepatitis

García

Matamala

Fernández

et al. 2013

Rev. esp. enferm. dig.

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Severe alcoholic hepatitis is associated with high early mortality. This study aimed at identifying prognostic factors associated with in-hospital, medium-and long-term mortality of severe alcoholic hepatitis and to evaluate the different prognostic scoring systems on a cohort of patients in our hospital. To this end, we conducted a retrospective analysis of 66 episodes admitted between 2000 and 2008. Clinical and laboratory data on admission, at 7 days, 1 month, 6 months, and after one year were collected and analyzed, as were the details on the treatment and complications that occurred during hospitalization; the different prognostic indices used in the literature were calculated. Death event associated with an episode of severe alcoholic hepatitis occurs primarily during the first month, with an average mortality rate of 16.9. Infectious complications were associated with lower in-hospital survival. MELD score, urea and bilirubin values one week after admission were independently associated with both in-hospital survival (OR = 1.14, 1.012 and 1.1, respectively), and survival at 6 months (OR = 1, 15; 1.014 and 1.016, respectively). Only MELD score and urea values at 7 days were independent predictors of survival twelve months after the acute hepatitis episode. MELD score, urea, and bilirubin 7 days after admission were the only independent in-hospital survival and also long-term survival factors 6 months and one year after the episode. In our cohort, the MELD score was the best prognostic index to predict mortality associated with an episode of severe alcoholic hepatitis.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors associated with mortality in patients with severe alcoholic hepatitis

García

Matamala

Fernández

et al. 2013

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

show abstract

“…However, the most consistent difference between patients with alcoholic hepatitis and other patients with decompensated ALD is the degree of hyperbilirubinaemia [4,5]. A recent review of all the randomised controlled trials of treatments for alcoholic hepatitis determined the accuracy of the clinical criteria used relative to subsequent histological confirmation.…”

Section: Is a Liver Biopsy Necessary In Alcoholic Hepatitis?mentioning

confidence: 99%

Is a liver biopsy necessary in alcoholic hepatitis?

Forrest

Gleeson

2012

Journal of Hepatology

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“…It concluded that patients with a high HVPG ([22 mmHg) and a high model for end-stage liver disease (MELD) score ( [25) were independently associated with an increased risk of in-hospital death [21]. A liver biopsy and the Maddrey discriminant function, as assessed by the following formula: {4.6 9 [prothrombin time-control time (s)]} ?…”

Section: Hepatic Venous Pressure Gradient In Patients With Alcoholic mentioning

confidence: 99%

Hepatic Venous Pressure Gradient: Worth Another Look?

Parikh

2008

Dig Dis Sci

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Portal hypertension is one of the most important complications of chronic liver disease and accounts for significant morbidity and mortality. Measurement of the hepatic venous pressure gradient (HVPG) is a simple, invasive, and reproducible method of assessing portal venous pressure. Measurement of HVPG provides the clinician an estimate of the degree of intrahepatic portal flow resistance, guides therapy for variceal bleeding (primary and secondary prophylaxis), assesses feasibility of resection in patients with hepatocellular cancer, and predicts response to therapy of patients with chronic hepatitis C. Achieving hemodynamic targets of reducing the HVPG to <10 mmHg or a 20% reduction from baseline virtually eliminates complications related to portal hypertension from chronic liver disease. This review explores the role of HVPG measurement in the contemporary treatment of patients with cirrhosis and portal hypertension.

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Prognostic value of hepatic venous pressure gradient for in‐hospital mortality of patients with severe acute alcoholic hepatitis

Cited by 83 publications

References 39 publications

Prognostic factors associated with mortality in patients with severe alcoholic hepatitis

Prognostic factors associated with mortality in patients with severe alcoholic hepatitis

Is a liver biopsy necessary in alcoholic hepatitis?

Hepatic Venous Pressure Gradient: Worth Another Look?

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