The Impact of Previous Acute Decompensation on the Long-Term Prognosis of Alcoholic Hepatitis in Cirrhotic Patientsopen access
- Yoon, Eileen L.; Kim, Tae Yeob; Song, Do Seon; Kim, Hee Yeon; Kim, Chang Wook; Jung, Young Kul; Sinn, Dong Hyun; Jang, Jae Young; Kim, Moon Young; Jeong, Soung Won; Kim, Sang Gyune; Suk, Ki Tae; Kim, Dong Joon; Han, Byung Hoon; Lee, Byung Seok; Lee, Chang Hyeong; Chae, Hee Bok; Kwon, Hyeok Choon; Lee, Heon Ju; Kim, Hyoung Su; Cho, Hyun Chin; Yim, Hyung Joon; Kim, Jeong Han; Suh, Jeong Ill; Yang, Jin Mo; Sohn, Joo Hyun; Lee, Sang Soo; Nam, Seong Woo; Park, Seung Ha; Baik, Soon Koo; Kim, Sung Eun; Kim, Tae Hun; Choe, Won Hyeok; Kim, Young Seok
- Issue Date
- alcoholic hepatitis; liver cirrhosis; acute decompensation; survival; mortality
- JOURNAL OF CLINICAL MEDICINE, v.8, no.10
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- 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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- College of Medicine > Department of Medicine > Journal Articles
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