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The Impact of Previous Acute Decompensation on the Long-Term Prognosis of Alcoholic Hepatitis in Cirrhotic Patientsopen access

Authors
Yoon, Eileen L.Kim, Tae YeobSong, Do SeonKim, Hee YeonKim, Chang WookJung, Young KulSinn, Dong HyunJang, Jae YoungKim, Moon YoungJeong, Soung WonKim, Sang GyuneSuk, Ki TaeKim, Dong JoonHan, Byung HoonLee, Byung SeokLee, Chang HyeongChae, Hee BokKwon, Hyeok ChoonLee, Heon JuKim, Hyoung SuCho, Hyun ChinYim, Hyung JoonKim, Jeong HanSuh, Jeong IllYang, Jin MoSohn, Joo HyunLee, Sang SooNam, Seong WooPark, Seung HaBaik, Soon KooKim, Sung EunKim, Tae HunChoe, Won HyeokKim, Young Seok
Issue Date
Oct-2019
Publisher
MDPI
Keywords
alcoholic hepatitis; liver cirrhosis; acute decompensation; survival; mortality
Citation
JOURNAL OF CLINICAL MEDICINE, v.8, no.10
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF CLINICAL MEDICINE
Volume
8
Number
10
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1622
DOI
10.3390/jcm8101600
ISSN
2077-0383
Abstract
Recurrent episodes of liver injury may either waste hepatic reserve or induce tolerance to further injury. We aimed to investigate whether the previous acute decompensation (AD) in liver cirrhosis (LC) affects the long-term transplant-free survival of patients with alcoholic hepatitis (AH). The survival data of 894 alcoholic LC cohort who had been admitted with acute deterioration in 21 academic hospitals in Korea were prospectively followed up. Enrolled patients were divided into three groups: Group 1, without AH; group 2, with nonsevere AH; and group 3, with severe AH. Although the baseline liver function was not different between the groups with or without previous AD, it was a significant predictor of poor long-term outcomes. The presence of previous AD negatively affected long-term overall survival (HR 1.62, 95% C.I. 1.20-2.18, p = 0.002) in groups 1 and 2 as a whole, independent of the Model for End-stage Liver Disease score. The three-month conditional survival was significantly worse in group 3 for up to 12 months in the presence of previous AD (p < 0.05). We concluded that not only the severity of AH, but also the prior AD is an important predictor of long-term outcomes in alcoholic LC patients with acute deterioration.
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Yim, Hyung Joon
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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