Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
Rattachement africain : es. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND AND AIMS: Alcohol relapse after surviving an episode of alcohol-associated hepatitis (AH) is common. However, the clinical features, risk factors, and prognostic implications of recurrent alcohol-associated hepatitis (RAH) are not well described. APPROACH AND RESULTS: A registry-based study was done of patients admitted to 28 Spanish hospitals for an episode of AH between 2014 and 2021. Baseline demographics and laboratory variables were collected. Risk factors for RAH were investigated using Cox regression analysis. We analyzed the severity of the index episodes of AH and compared it to that of RAH. Long-term survival was assessed by Kaplan-Meier curves and log-rank tests. A total of 1118 patients were included in the analysis, 125 (11%) of whom developed RAH during follow-up (median: 17 [7-36] months). The incidence of RAH in patients resuming alcohol use was 22%. The median time to recurrence was 14 (8-29) months. Patients with RAH had more psychiatric comorbidities. Risk factors for developing RAH included age <50 years, alcohol use >10 U/d, and history of liver decompensation. RAH was clinically more severe compared to the first AH (higher MELD, more frequent ACLF, and HE). Moreover, alcohol abstinence during follow-up was less common after RAH (18% vs. 45%, p <0.001). Most importantly, long-term mortality was higher in patients who developed RAH (39% vs. 21%, p = 0.026), and presenting with RAH independently predicted high mortality (HR: 1.55 [1.11-2.18]). CONCLUSIONS: RAH is common and has a more aggressive clinical course, including increased mortality. Patients surviving an episode of AH should undergo intense alcohol use disorder therapy to prevent RAH.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
- Date Crossref
- 05/03/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Hospital Clínic de Barcelona Department of Liver Diseases pays non établi dans la noticeÉtablissement de santé
-
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas pays non établi dans la noticeStructure de recherche
-
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer pays non établi dans la noticeStructure de recherche
-
Hospital Universitario Virgen del Rocío Department of Digestive Diseases pays non établi dans la noticeÉtablissement de santé
-
Hospital Universitario Central de Asturias Department of Liver Diseases pays non établi dans la noticeÉtablissement de santé
-
Universitat Autònoma de Barcelona pays non établi dans la noticeUniversité ou école supérieure
-
Vall d'Hebron Institut de Recerca pays non établi dans la noticeStructure de recherche
-
Hospital de Sant Pau pays non établi dans la noticeÉtablissement de santé
-
Hospital Universitario Ramón y Cajal Department of Gastroenterology and Hepatology pays non établi dans la noticeÉtablissement de santé
-
Marqués de Valdecilla University Hospital pays non établi dans la noticeÉtablissement de santé
-
Deleted Institution pays non établi dans la noticeStructure de recherche
-
Hospital Universitari i Politècnic La Fe Department of Hepatology and Liver Transplant pays non établi dans la noticeÉtablissement de santé
Department of Liver Diseases — Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas et Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.