Prognostic Factors for Short‐Term Survival in Alcoholic Hepatitis in Japan: Analysis by Logistic Regression

Abstract

Prognostic factors for the outcome of patients with alcoholic hepatitis were identified by logistic regression analysis. To predict the outcome immediately after admission, clinical data from 97 patients with alcoholic hepatitis on admission were introduced to multivariate analysis. Independent prognostic factors for favorable outcome were hepaplastin time, peripheral white blood cell count, age (40 to 60 years), and serum creatinine level (below 1.4 mg/dl). Sensitivity, specificity, positive predictive value, negative predictive value, and predictive accuracy were 0.78, 0.89, 0.78, 0.89, and 0.86, respectively. The resultant equation for the death rate was applied to another set of patients with alcoholic hepatitis as a validation study. Predictive accuracy estimated 0.95 in validation. The prognostic index derived was simple, accurate, and useful in the prediction of the outcome in patients with alcoholic hepatitis. Furthermore, it provides the clinician with an indication of the necessity for the intensive care of patients in a critical condition.

Risk Factors for Mortality in Patients with Alcoholic Hepatitis and Assessment of Prognostic Models: A Population-Based Study

“…In the present population-based study from a large Canadian metropolitan centre, we describe prognostic factors and the predictive utility of well-known risk scores in patients hospitalized for AH. As expected, older age and indicators of greater hepatic and renal dysfunction were associated with 90-day mortality (9,31). In univariate analysis, patients who died had higher MELD and Maddrey DF scores, and greater INR and serum creatinine concentrations, supporting the prognostic significance of these factors.…”

The value of model for end‐stage liver disease and Child–Turcotte–Pugh scores over time in evaluating the prognosis of patients with decompensated cirrhosis: experience in the Chinese mainland

“…The association between mortality and bilirubin, creatinine and encephalopathy has been previously reported 22,23 . In a multivariate analysis, our results confirmed that encephalopathy, bilirubin and creatinine were independently associated with 3‐month mortality.…”

Severe Alcoholic Hepatitis Successfully Treated by Leukocytapheresis: A Case Report

“…The risk of mortality in this case was 98% on admission, according to the formula reported by Kumashiro et al (1996), and we believed that his prognosis was very poor. The formula for the predictive prognosis of SAH is as follows:…”

“…The standard treatment methods include prednisolone (PSL) and nutritional support; however, the survival rate in Japan is approximately 20%, suggesting that we do not yet have an established treatment modality for this disease. Here we report a case of SAH in which a high risk to mortality was suggested by multivariate analysis (Kumashiro et al, 1996). We applied a new treatment with granulocyte and monocyte adsorption apheresis (GCAP) using an Adacolumn (JIMRO, Takasaki, Japan).…”