2026-04-18T01:58:19Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/130162025-10-24T10:17:50Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Muñoz, Karen
author
Caldentey, Vicente
author
Idalsoaga, Francisco
author
Díaz, Luis Antonio
author
Dunn, Winston
author
Mehta, Heer
author
Ventura-Cots, Meritxell
2025-10-24T10:17:50Z
2025-10-24T10:17:50Z
2025-04-30T06:39:26Z2025-04-30T06:39:26Z2025-04
http://hdl.handle.net/11351/13016
Moderate alcohol-associated hepatitis; Mortality; SurvivalHepatitis moderada associada a l'alcohol; Mortalitat; SupervivènciaHepatitis moderada asociada al alcohol; Mortalidad; SupervivenciaBackground:
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.Marco Arrese receives support from the Chilean government through the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT 1241450).
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Hepatitis - Mortalitat
Alcoholisme - Complicacions
Hepatitis - Prognosi
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis
DISEASES::Digestive System Diseases::Liver Diseases::Hepatitis::Hepatitis, Alcoholic
Other subheadings::Other subheadings::Other subheadings::Other subheadings::/mortality
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico
ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::hepatitis::hepatitis alcohólica
Otros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad
Moderate alcohol-associated hepatitis: A real-world multicenter study
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion