Browsing by Author "Caldentey, Vicente"

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    Moderate alcohol-associated hepatitis: A real-world multicenter study
    (2025) Idalsoaga Ferrer, Francisco Javier; Diaz, Luis Antonio; Dunn, Winston; Mehta, Heer; Munoz, Karen; Caldentey, Vicente; Arnold, Jorge; Ayares, Gustavo; Mortuza, Rokhsana; Sarin, Shiv K.; Maiwall, Rakhi; Zhang, Wei; Qian, Steve; Simonetto, Douglas; Singal, Ashwani K.; Elfeki, Mohamed A.; Ramirez-Cadiz, Carolina; Malhi, Gurpreet; Ahmed, Adan; Homsi, Hoomam; Abid, Zinia; Cabezas, Joaquin; Echavarria, Victor; Poca, Maria; Soriano, German; Cuyas, Berta; Cots, Meritxell Ventura; Higuera-De La Tijera, Maria Fatima; Ayala-Valverde, Maria; Perez, Diego; Gomez, Jaime; Abraldes, Juan G.; Al-Karaghouli, Mustafa; Jalal, Prasun K.; Ibrahim, Mohamad A.; Garcia-Tsao, Guadalupe; Goyes, Daniela; Skladany, Lubomir; Havaj, Daniel J.; Sulejova, Karolina; Selcanova, Svetlana Adamcova; Rincon, Diego; Chacko, Kristina R.; Restrepo, Juan C.; Yaquich, Pamela; Toro, Luis G.; Shah, Vijay; Arrese Jiménez, Marco Antonio; Kamath, Patrick S.; Bataller, Ramon; Arab Verdugo, Juan Pablo
    Background: Severe alcohol-associated hepatitis (sAH) is a well-characterized disease with high short-term mortality. However, there is limited research on those with a "less severe condition" (moderate AH). This study aims to characterize in-depth patients with moderate AH (mAH), including the performance of mortality scoring systems, key prognostic factors, and survival over time. Methods:A multicenter retrospective cohort study (2009-2019) included patients with mAH (MELD score <= 20 at admission). Cox regression and receiver operating characteristic curves with AUC were used for analysis. Results:We included 1845 patients with AH (20 centers, 8 countries) between 2009 and 2019. mAH was defined as a MELD score <= 20 at admission. Twenty-four percent met the criteria for an mAH episode. Patients with mAH tend to be older and have a higher proportion of females, with a median MELD of 17 (15-19), Maddrey discriminant function (mDF) of 33 (22-40), the trajectory of serum bilirubin of 0.83 (0.60-1.21), and neutrophil-to-lymphocyte ratio (NLR) of 5 (2.96-8.60). The primary causes of death in mAH included multiple organ failure (34.1%) and infections (16.6%). The cumulative survival rates at 30, 90, and 180 days were 94.3%, 90.4%, and 88.2%, respectively. In multivariable analysis, age was the only significant predictor of 30-day mortality (HR 1.49, 95% CI: 1.27-1.76, p<0.001). Mortality prediction models showed poor performance, with AUC for MELD (0.671), mDF (0.726), trajectory of serum bilirubin (0.733), and NLR (0.697). Conclusions:Patients with moderate AH exhibited a mortality of 11.8% at 6 months, primarily driven by multiple organ failure and infections. These patients also exhibit a different clinical profile compared to those with sAH. Tailored models and therapeutic strategies are needed to improve long-term outcomes in mAH.
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    Moderate alcohol-associated hepatitis: A real-world multicenter study
    (Springer, 2025) Idalsoaga Ferrer, Francisco Javier; Diaz, Luis Antonio; Dunn, Winston; Mehta, Heer; Munoz, Karen; Caldentey, Vicente; Arnold, Jorge; Ayares, Gustavo; Mortuza, Rokhsana; Sarin, Shiv K.; Maiwall, Rakhi; Zhang, Wei; Qian, Steve; Simonetto, Douglas; Singal, Ashwani K.; Elfeki, Mohamed A.; Ramirez-Cadiz, Carolina; Malhi, Gurpreet; Ahmed, Adan; Homsi, Hoomam; Abid, Zinia; Cabezas, Joaquin; Echavarria, Victor; Poca, Maria; Soriano, German; Cuyas, Berta; Cots, Meritxell Ventura; Higuera-De La Tijera, Maria Fatima; Ayala-Valverde, Maria; Perez, Diego; Gomez, Jaime; Abraldes, Juan G.; Al-Karaghouli, Mustafa; Jalal, Prasun K.; Ibrahim, Mohamad A.; Garcia-Tsao, Guadalupe; Goyes, Daniela; Skladany, Lubomir; Havaj, Daniel J.; Sulejova, Karolina; Selcanova, Svetlana Adamcova; Rincon, Diego; Chacko, Kristina R.; Restrepo, Juan C.; Yaquich, Pamela; Toro, Luis G.; Shah, Vijay; Arrese Jiménez, Marco Antonio; Kamath, Patrick S.; Bataller, Ramon; Arab Verdugo, Juan Pablo
    Background: Severe alcohol-associated hepatitis (sAH) is a well-characterized disease with high short-term mortality. However, there is limited research on those with a "less severe condition" (moderate AH). This study aims to characterize in-depth patients with moderate AH (mAH), including the performance of mortality scoring systems, key prognostic factors, and survival over time. Methods:A multicenter retrospective cohort study (2009-2019) included patients with mAH (MELD score <= 20 at admission). Cox regression and receiver operating characteristic curves with AUC were used for analysis. Results:We included 1845 patients with AH (20 centers, 8 countries) between 2009 and 2019. mAH was defined as a MELD score <= 20 at admission. Twenty-four percent met the criteria for an mAH episode. Patients with mAH tend to be older and have a higher proportion of females, with a median MELD of 17 (15-19), Maddrey discriminant function (mDF) of 33 (22-40), the trajectory of serum bilirubin of 0.83 (0.60-1.21), and neutrophil-to-lymphocyte ratio (NLR) of 5 (2.96-8.60). The primary causes of death in mAH included multiple organ failure (34.1%) and infections (16.6%). The cumulative survival rates at 30, 90, and 180 days were 94.3%, 90.4%, and 88.2%, respectively. In multivariable analysis, age was the only significant predictor of 30-day mortality (HR 1.49, 95% CI: 1.27-1.76, p<0.001). Mortality prediction models showed poor performance, with AUC for MELD (0.671), mDF (0.726), trajectory of serum bilirubin (0.733), and NLR (0.697). Conclusions:Patients with moderate AH exhibited a mortality of 11.8% at 6 months, primarily driven by multiple organ failure and infections. These patients also exhibit a different clinical profile compared to those with sAH. Tailored models and therapeutic strategies are needed to improve long-term outcomes in mAH.