New prognostic model for hospitalized patients with alcoholic cirrhosis and Maddrey's discriminant function <32
- Authors
- Kim, Tae Hyung; Yim, Hyung Joon; Jung, Young Kul; Song, Do Seon; Yoon, Eileen L.; Kim, Hee Yeon; Kang, Seong Hee; Chang, Young; Yoo, Jeong-Ju; Jun, Baek Gyu; Lee, Sung Won; Park, Jung Gil; Park, Ji Won; Kim, Sung-Eun; Kim, Tae Yeob; Jeong, Soung Won; Suk, Ki Tae; Kim, Moon Young; Kim, Sang Gyune; Kim, Won; Jang, Jae Young; Yang, Jin Mo; Kim, Dong Joon
- Issue Date
- Oct-2023
- Publisher
- Springer Pub. Co.
- Keywords
- Alcoholic hepatitis; Cirrhosis; Prognosis; Prediction; Maddrey's discriminant function; Deterioration; Neutrophil; Vasopressor; Sodium
- Citation
- Hepatology International
- Indexed
- SCIE
SCOPUS
- Journal Title
- Hepatology International
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64340
- DOI
- 10.1007/s12072-023-10582-1
- ISSN
- 1936-0533
1936-0541
- Abstract
- Background & aims Few studies have investigated the prognosis of patients with non-severe alcoholic hepatitis (Non-SAH). The study aimed to develop a new prognostic model for patients with especially Non-SAH.Methods We extracted 316 hospitalized patients with alcoholic cirrhosis without severe alcoholic hepatitis, defined as Maddrey's discriminant function score lower than 32, from the retrospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort to develop a new prognostic model (training set), and validated it in 419 patients from the prospective KACLiF cohort (validation set). Prognostic factors for death and liver transplantation were analyzed to construct a prognostic model.Results Twenty-one and 24 patients died within 6 months in both sets, respectively. In the training set, the highest area under the curve (AUC) of conventional prognostic models was 0.765, 0.732, and 0.684 for 1-, 3-, and 6-month mortality, respectively. Refractory ascites, vasopressor use, and hyponatremia were independently associated with mortality of cirrhotic patients with Non-SAH. The new model consisted of four variables: past deterioration, neutrophil proportion > 70%, Na < 128 mmol/L, and vasopressor use. It showed the highest accuracy for short-term mortality in the training and validation sets (0.803 and 0.786; 0.797 and 0.776; and 0.789 and 0.721 for 1-, 3-, and 6-month mortality, respectively).Conclusion There is a group of patients with high risk among those classified as Non-SAH. The new model will help stratifying cirrhotic patients with Non-SAH more accurately in terms of prognosis. The patients with high Non-SAH score need to monitor closely and might be considered for preemptive liver transplantation.
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Collections - 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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