Evaluation of Prognostic Parameters for Assessment of Efficacy of Steroid Therapy at Day 7 in Patients with Severe Alcoholic Hepatitis
Journal Title: International Journal of Contemporary Medical Research - Year 2016, Vol 3, Issue 8
Abstract
Introduction: Alcoholic Hepatitis (AH) is an acute inflammatory condition occurring in patients with alcoholic abuse. Currently steroids are the treatment modality in it so the present study was done to evaluate factors associated with poor response to steroid therapy in patients with severe alcoholic hepatitis and compare prognostic parameters in predicting efficacy of steroid therapy at day 7. Material and Methods: This is a prospective comparative study conducted for a period of 2 years, Data was collected prospectively of 55 patients with diagnosis of severe alcoholic hepatitis who satisfied inclusion/exclusion criteria. Results: Alcoholic hepatitis remains associated with high short term mortality in hospitalized patients. The 30 day mortality of severe AH in the current study was 40%. Alcoholic hepatitis was most common in males between 40-50 years old. With median age of 46.9 ± 7.7 (31 – 60) years. Edema/ascites were noted in 78.2%, liver decompensation in 76%, cirrhosis in 34.5% and portal hypertension was present in 67.2% patients. The clinical complications consisted of Asterixis and HE in 40%, HRS and renal failure in 18.2% and 40% patients developed infections. HRS, HE, LFTs, RFTs, Na+ and all scores including MDF, MELD, CTP showed significant association with in hospital mortality at 30 days on univariate analysis. Conclusion: The CTP, MELD, DF, GAHS, UKELD, and ABIC, as well as those of MDF, MELD obtained at day7 had excellent positive and negative predictive values on ROC curve analysis but at a higher cut-off value.
Authors and Affiliations
B. Ramesh Kumar, K. Ravikanth, K. Panduranga Rao
Keywords
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