Impact of Karnofsky performance status on outcomes of patients with severe alcohol-associated hepatitis: a propensity-matched analysis

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dc.contributor.authorKulkarni, Anand V.
dc.contributor.authorVenishetty, Shantan
dc.contributor.authorKumar, Karan
dc.contributor.authorGurav, Nitish
dc.contributor.authorAlbhaisi, Somaya
dc.contributor.authorChhabbra, Prateek
dc.contributor.authorShaik, Sameer
dc.contributor.authorAlla, Manasa
dc.contributor.authorIyengar, Sowmya
dc.contributor.authorSharma, Mithun
dc.contributor.authorRao, Padaki N.
dc.contributor.authorArab, Juan P.
dc.contributor.authorReddy, Duvvur N.
dc.date.accessioned2025-01-20T16:05:04Z
dc.date.available2025-01-20T16:05:04Z
dc.date.issued2024
dc.description.abstractBackground and Aims: Severity scores, including the model for end-stage liver disease (MELD) and discriminant function score, guide the treatment of patients with severe alcohol-associated hepatitis (AH). We aimed to investigate the impact of functional status on outcomes of patients with AH. Methods: Medically managed patients (n = 133) with AH from 1 January 2019 to 31 December 2022 were included in this prospective study. The objectives were to compare the long-term survival, recompensation rates, corticosteroid response, incidence of infections, hepatic encephalopathy (HE) and acute kidney injury (AKI) among propensity score-matched patients with good Karnofsky performance status (KPS) (score >= 50) and poor KPS (score <50) using Kaplan-Meier analysis. Results: Twenty-five patients with good KPS were matched with 25 patients with poor KPS and followed up for a median duration of 10 (0.5-33) months. Survival was 76% (19/25; 95% confidence interval (CI), 54.9-90.6) in patients with good KPS compared to 42.3% (11/25; 95% CI, 23.4-63.1) patients with poor KPS (P = 0.001) at 10 months. The recompensation rate was higher in the good KPS group than in the poor KPS group (68% vs 44%; P = 0.04). A higher proportion of patients in the good KPS group (78.9%) than in the poor KPS group (42.8%; P = 0.03) responded to corticosteroids. Survival was lower among non-responders in the poor KPS group (0% vs 75%; P = 0.01). The proportion of patients who developed infection (36% vs 28%; P = 0.051), HE (36% vs 12%; P = 0.01) and AKI (60% vs 16%; P < 0.001) was higher in patients with poor KPS than in good KPS. Conclusions: KPS is an important determinant of outcomes in patients with AH, including survival, recompensation, response to corticosteroids and complications.
dc.fuente.origenWOS
dc.identifier.doi10.1111/imj.16562
dc.identifier.eissn1445-5994
dc.identifier.issn1444-0903
dc.identifier.urihttps://doi.org/10.1111/imj.16562
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/89863
dc.identifier.wosidWOS:001343596500001
dc.language.isoen
dc.revistaInternal medicine journal
dc.rightsacceso restringido
dc.subjectfunctional status
dc.subjectsteroid response
dc.subjectrecompensation
dc.subjectmDF
dc.titleImpact of Karnofsky performance status on outcomes of patients with severe alcohol-associated hepatitis: a propensity-matched analysis
dc.typeartículo
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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