Moderate alcohol-associated hepatitis: A real-world multicenter study

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dc.article.numbere0673
dc.catalogadorjca
dc.contributor.authorIdalsoaga Ferrer, Francisco Javier
dc.contributor.authorDiaz, Luis Antonio
dc.contributor.authorDunn, Winston
dc.contributor.authorMehta, Heer
dc.contributor.authorMunoz, Karen
dc.contributor.authorCaldentey, Vicente
dc.contributor.authorArnold, Jorge
dc.contributor.authorAyares, Gustavo
dc.contributor.authorMortuza, Rokhsana
dc.contributor.authorSarin, Shiv K.
dc.contributor.authorMaiwall, Rakhi
dc.contributor.authorZhang, Wei
dc.contributor.authorQian, Steve
dc.contributor.authorSimonetto, Douglas
dc.contributor.authorSingal, Ashwani K.
dc.contributor.authorElfeki, Mohamed A.
dc.contributor.authorRamirez-Cadiz, Carolina
dc.contributor.authorMalhi, Gurpreet
dc.contributor.authorAhmed, Adan
dc.contributor.authorHomsi, Hoomam
dc.contributor.authorAbid, Zinia
dc.contributor.authorCabezas, Joaquin
dc.contributor.authorEchavarria, Victor
dc.contributor.authorPoca, Maria
dc.contributor.authorSoriano, German
dc.contributor.authorCuyas, Berta
dc.contributor.authorCots, Meritxell Ventura
dc.contributor.authorHiguera-De La Tijera, Maria Fatima
dc.contributor.authorAyala-Valverde, Maria
dc.contributor.authorPerez, Diego
dc.contributor.authorGomez, Jaime
dc.contributor.authorAbraldes, Juan G.
dc.contributor.authorAl-Karaghouli, Mustafa
dc.contributor.authorJalal, Prasun K.
dc.contributor.authorIbrahim, Mohamad A.
dc.contributor.authorGarcia-Tsao, Guadalupe
dc.contributor.authorGoyes, Daniela
dc.contributor.authorSkladany, Lubomir
dc.contributor.authorHavaj, Daniel J.
dc.contributor.authorSulejova, Karolina
dc.contributor.authorSelcanova, Svetlana Adamcova
dc.contributor.authorRincon, Diego
dc.contributor.authorChacko, Kristina R.
dc.contributor.authorRestrepo, Juan C.
dc.contributor.authorYaquich, Pamela
dc.contributor.authorToro, Luis G.
dc.contributor.authorShah, Vijay
dc.contributor.authorArrese Jiménez, Marco Antonio
dc.contributor.authorKamath, Patrick S.
dc.contributor.authorBataller, Ramon
dc.contributor.authorArab Verdugo, Juan Pablo
dc.date.accessioned2025-05-06T19:59:04Z
dc.date.available2025-05-06T19:59:04Z
dc.date.issued2025
dc.description.abstractBackground: 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.
dc.description.funderChilean government through the Fondo Nacional de Desarrollo Cientifico y Tecnologico
dc.fechaingreso.objetodigital2025-05-06
dc.format.extent11 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1097/HC9.0000000000000673
dc.identifier.eissn2471-254X
dc.identifier.urihttps://doi.org/10.1097/HC9.0000000000000673
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104035
dc.identifier.wosidWOS:001451193800001
dc.information.autorucEscuela de Medicina; Idalsoaga Ferrer, Francisco Javier; S/I; 1017394
dc.information.autorucEscuela de Medicina; Arab Verdugo, Juan Pablo; 0000-0002-8561-396X; 132745
dc.information.autorucEscuela de Medicina; Arrese Jiménez, Marco Antonio; 0000-0002-0499-4191; 76095
dc.issue.numero4
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaHepatology Communications
dc.rightsacceso abierto
dc.subjectAlcohol
dc.subjectAlcohol-associated hepatitis
dc.subjectAlcohol-associated liver disease
dc.subjectCirrhosis
dc.subjectEnd-stage liver disease
dc.subjectOutcome prediction
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleModerate alcohol-associated hepatitis: A real-world multicenter study
dc.typeartículo
dc.volumen9
sipa.codpersvinculados1017394
sipa.codpersvinculados132745
sipa.codpersvinculados76095
sipa.trazabilidadWOS;2025-04-05
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