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Prognostic and diagnostic scoring models in acute alcohol-associated hepatitis: A review comparing the performance of different scoring systems.

作者信息

Mitri Jad, Almeqdadi Mohammad, Karagozian Raffi

机构信息

Department of Medicine, Saint Elizabeth's Medical Center, Boston, MA 02135, United States.

Division of Transplant and Hepatobiliary Disease, Tufts Medical Center, Boston, MA 02111, United States.

出版信息

World J Hepatol. 2023 Aug 27;15(8):954-963. doi: 10.4254/wjh.v15.i8.954.


DOI:10.4254/wjh.v15.i8.954
PMID:37701919
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10494564/
Abstract

Alcohol-associated hepatitis (AAH) is a severe form of liver disease caused by alcohol consumption. In the absence of confounding factors, clinical features and laboratory markers are sufficient to diagnose AAH, rule out alternative causes of liver injury and assess disease severity. Due to the elevated mortality of AAH, assessing the prognosis is a radical step in management. The Maddrey discriminant function (MDF) is the first established clinical prognostic score for AAH and was commonly used in the earliest AAH clinical trials. A MDF > 32 indicates a poor prognosis and a potential benefit of initiating corticosteroids. The model for end stage liver disease (MELD) score has been studied for AAH prognostication and new evidence suggests MELD may predict mortality more accurately than MDF. The Lille score is usually combined to MDF or MELD score after corticosteroid initiation and offers the advantage of assessing response to treatment a 4-7 d into the course. Other commonly used scores include the Glasgow Alcoholic Hepatitis Score and the Age Bilirubin international normalized ratio Creatinine model. Clinical AAH correlate adequately with histologic severity scores and leave little indication for liver biopsy in assessing AAH prognosis. AAH presenting as acute on chronic liver failure (ACLF) is so far prognosticated with ACLF-specific scoring systems. New artificial intelligence-generated prognostic models have emerged and are being studied for use in AAH. Acute kidney injury (AKI) is one possible complication of AAH and is significantly associated with increased AAH mortality. Predicting AKI and alcohol relapse are important steps in the management of AAH. The aim of this review is to discuss the performance and limitations of different scoring models for AAH mortality, emphasize the most useful tools in prognostication and review predictors of recurrence.

摘要

相似文献

[1]
Prognostic and diagnostic scoring models in acute alcohol-associated hepatitis: A review comparing the performance of different scoring systems.

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[2]
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引用本文的文献

[1]
Assessing Efficacy of Interleukin-1 Blockade in Patients with Alcoholic Hepatitis: A Comprehensive Systematic Review of Emerging Evidence.

Life (Basel). 2025-7-15

[2]
A comprehensive review of diagnosis and management of alcohol-associated hepatitis.

SAGE Open Med. 2024-11-8

[3]
Advances in the management of alcohol-associated liver disease.

Gastroenterol Rep (Oxf). 2024-11-5

[4]
Insights into ALD and AUD diagnosis and prognosis: Exploring AI and multimodal data streams.

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本文引用的文献

[1]
An artificial intelligence-generated model predicts 90-day survival in alcohol-associated hepatitis: A global cohort study.

Hepatology. 2024-11-1

[2]
Alcohol-Associated Hepatitis.

N Engl J Med. 2022-12-29

[3]
Alcohol and Acute-on-Chronic Liver Failure.

J Clin Exp Hepatol. 2022

[4]
Evaluation of Trends in Alcohol Use Disorder-Related Mortality in the US Before and During the COVID-19 Pandemic.

JAMA Netw Open. 2022-5-2

[5]
The Mortality Index for Alcohol-Associated Hepatitis: A Novel Prognostic Score.

Mayo Clin Proc. 2022-3

[6]
The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study.

Am J Gastroenterol. 2022-2-1

[7]
The Pandemic Within the Pandemic: Unprecedented Rise in Alcohol-related Hepatitis During the COVID-19 Pandemic.

J Clin Gastroenterol. 2022-3-1

[8]
Trends in Liver Transplantation for Acute Alcohol-Associated Hepatitis During the COVID-19 Pandemic in the US.

JAMA Netw Open. 2021-7-1

[9]
Current Trends in Liver Transplantation for Alcoholic Hepatitis.

Clin Liver Dis. 2021-8

[10]
Scoring systems to assess relapse risk in alcohol use disorder presenting for early liver transplantation: A systematic review.

Gen Hosp Psychiatry. 2021

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