Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients
Introduction: Alcohol abuse causes a variety of liver diseases including alcoholic steatosis, alcoholic hepatitis (AH), liver fibrosis, cirrhosis, and hepatocellular carcinoma. AH is a clinical syndrome which typically occurs after the harmful use of alcohol. There are mild forms that are likely to...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-05-01
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| Series: | Journal of Marine Medical Society |
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| Online Access: | https://journals.lww.com/10.4103/jmms.jmms_109_24 |
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| author | Priyank Dhiman Ritu Grewal Pankaj Puri Neel Kanth Issar AS Prasad Rahul Jain Manasvi Kalra Harshul Jain |
| author_facet | Priyank Dhiman Ritu Grewal Pankaj Puri Neel Kanth Issar AS Prasad Rahul Jain Manasvi Kalra Harshul Jain |
| author_sort | Priyank Dhiman |
| collection | DOAJ |
| description | Introduction:
Alcohol abuse causes a variety of liver diseases including alcoholic steatosis, alcoholic hepatitis (AH), liver fibrosis, cirrhosis, and hepatocellular carcinoma. AH is a clinical syndrome which typically occurs after the harmful use of alcohol. There are mild forms that are likely to improve with conservative management, whereas severe cases are associated with a high mortality rate and have a high risk of death despite treatment. The identification of severe AH is important, as this can be associated with 30%–50% short-term mortality. Existing prognostic scores have been validated in the western population, and the data of application in the Indian population are scant.
Materials and Methods:
It is a prospective observational study conducted for 2 years at Tertiary Care Hospital Army Hospital (Research and Referral) Delhi. The sample size was kept to be 45. For each patient, clinical and laboratory values were obtained on the day of admission and used to calculate the prognostic models according to their formulas. The various scores – Maddrey’s discriminant function (mDF), Glasgow AH score (GAHS), age, bilirubin, international normalized ratio (INR), creatinine score, and model of end-stage liver disease (MELD) including its modification MELD-sodium were calculated. For patients started on steroids, early changes in bilirubin level and Lille score were calculated.
Results:
All the prognostic scores were found to be good predictors of mortality. When compared with each other, MELD was most indicative of mortality with maximum area under the receiver operating characteristic curve. All the scores were significantly higher in the nonsurvivors than the survivors (P < 0.0001).
Conclusion:
AH is a clinical syndrome that occurs after the harmful use of alcohol and confers a high mortality. Effective treatment and support for patients with AH is dependent on a proper assessment of the disease severity and estimation of the risk of death as early in the course of the disease as possible. |
| format | Article |
| id | doaj-art-e7ef12e9d220487997c3c4d751a133e5 |
| institution | OA Journals |
| issn | 0975-3605 2589-1235 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Marine Medical Society |
| spelling | doaj-art-e7ef12e9d220487997c3c4d751a133e52025-08-20T02:16:09ZengWolters Kluwer Medknow PublicationsJournal of Marine Medical Society0975-36052589-12352025-05-0127216316710.4103/jmms.jmms_109_24Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian PatientsPriyank DhimanRitu GrewalPankaj PuriNeel Kanth IssarAS PrasadRahul JainManasvi KalraHarshul JainIntroduction: Alcohol abuse causes a variety of liver diseases including alcoholic steatosis, alcoholic hepatitis (AH), liver fibrosis, cirrhosis, and hepatocellular carcinoma. AH is a clinical syndrome which typically occurs after the harmful use of alcohol. There are mild forms that are likely to improve with conservative management, whereas severe cases are associated with a high mortality rate and have a high risk of death despite treatment. The identification of severe AH is important, as this can be associated with 30%–50% short-term mortality. Existing prognostic scores have been validated in the western population, and the data of application in the Indian population are scant. Materials and Methods: It is a prospective observational study conducted for 2 years at Tertiary Care Hospital Army Hospital (Research and Referral) Delhi. The sample size was kept to be 45. For each patient, clinical and laboratory values were obtained on the day of admission and used to calculate the prognostic models according to their formulas. The various scores – Maddrey’s discriminant function (mDF), Glasgow AH score (GAHS), age, bilirubin, international normalized ratio (INR), creatinine score, and model of end-stage liver disease (MELD) including its modification MELD-sodium were calculated. For patients started on steroids, early changes in bilirubin level and Lille score were calculated. Results: All the prognostic scores were found to be good predictors of mortality. When compared with each other, MELD was most indicative of mortality with maximum area under the receiver operating characteristic curve. All the scores were significantly higher in the nonsurvivors than the survivors (P < 0.0001). Conclusion: AH is a clinical syndrome that occurs after the harmful use of alcohol and confers a high mortality. Effective treatment and support for patients with AH is dependent on a proper assessment of the disease severity and estimation of the risk of death as early in the course of the disease as possible.https://journals.lww.com/10.4103/jmms.jmms_109_24alcoholic hepatitisalcoholic liver diseaseprognostic scores |
| spellingShingle | Priyank Dhiman Ritu Grewal Pankaj Puri Neel Kanth Issar AS Prasad Rahul Jain Manasvi Kalra Harshul Jain Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients Journal of Marine Medical Society alcoholic hepatitis alcoholic liver disease prognostic scores |
| title | Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients |
| title_full | Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients |
| title_fullStr | Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients |
| title_full_unstemmed | Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients |
| title_short | Comparison of Different Prognostic Scoring Systems in Predicting the Severity and Outcome in Alcoholic Hepatitis in Indian Patients |
| title_sort | comparison of different prognostic scoring systems in predicting the severity and outcome in alcoholic hepatitis in indian patients |
| topic | alcoholic hepatitis alcoholic liver disease prognostic scores |
| url | https://journals.lww.com/10.4103/jmms.jmms_109_24 |
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