2026-04-17T04:56:07Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/130162025-10-24T10:17:50Zcom_2072_378070com_2072_378040col_2072_378092

Moderate alcohol-associated hepatitis: A real-world multicenter study Muñoz, Karen Caldentey, Vicente Idalsoaga, Francisco Díaz, Luis Antonio Dunn, Winston Mehta, Heer Ventura-Cots, Meritxell 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; Mortality; Survival Hepatitis moderada associada a l'alcohol; Mortalitat; Supervivència Hepatitis moderada asociada al alcohol; Mortalidad; Supervivencia 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. Marco Arrese receives support from the Chilean government through the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT 1241450). 2025-10-24T10:17:50Z 2025-10-24T10:17:50Z 2025-10-24T10:17:50Z 2025-04-30T06:39:26Z 2025-04-30T06:39:26Z 2025-04 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/13016 Hepatology Communications;9(4) https://doi.org/10.1097/HC9.0000000000000673 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Wolters Kluwer Health Scientia