Prognostic value of relative adrenal insufficiency in patients with severe alcohol-associated hepatitis-a prospective clinical study.

Autor:	Jiménez-Castillo RA; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico., González-Martínez CE; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico; Plataforma INVEST Medicina UANL, KER Unit Mayo Clinic (KER Unit Mexico), Universidad Autónoma de Nuevo León, Monterrey, México; Endocrinology Division, Department of Internal Medicine, University Hospital 'Dr. José E. González', Universidad Autónoma de Nuevo León, Monterrey, México., Tovar-Bojorquez EM; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico., Cortez-Hernández CA; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico. Electronic address: drcarloscortezz@hotmail.com., Jaquez-Quintana JO; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico., González-González JA; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico., González-González JG; Plataforma INVEST Medicina UANL, KER Unit Mayo Clinic (KER Unit Mexico), Universidad Autónoma de Nuevo León, Monterrey, México; Endocrinology Division, Department of Internal Medicine, University Hospital 'Dr. José E. González', Universidad Autónoma de Nuevo León, Monterrey, México., Maldonado-Garza HJ; Gastroenterology Department, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Jazyk:	English; Spanish; Castilian
Zdroj:	Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2024 Dec 12, pp. 502322. Date of Electronic Publication: 2024 Dec 12.
DOI:	10.1016/j.gastrohep.2024.502322
Abstrakt:	Background/aims: Relative adrenal insufficiency (RAI) is frequent in patients with liver cirrhosis and affects their prognosis. Scarce data on RAI in patients with alcohol-associated hepatitis (AAH) exists. This study aimed to document the prevalence and prognostic implication of RAI in patients with severe AAH. Patients and Methods: Adults with a first episode of AAH were selected. The delta cortisol level was the difference between the serum basal cortisol and 60 minutes after ACTH stimulation. Cox proportional-hazard regression model was used for univariate analysis of prognostic factors with 95% confidence intervals. The Kaplan-Meier and log-rank tests were applied for survival analysis between patients with RAI and without RAI. Results: Twenty-five subjects with a first episode of AAH were included. Eight (32.0%) deaths occurred in our cohort. Univariate analysis showed that presence of RAI (p = 0.049) had a significant impact on 90-day Overall Survival (OS). Serum albumin (p = 0.991), serum creatinine (p = 0.954), sodium (p = 0.986) and international normalized ratio (p = 0.073) did not show a significant impact on 90-day OS. Ninety-day overall survival for patients with RAI was 50.0% vs. 90.9% in those without RAI, (p=0.040). Conclusions: The presence of RAI seems to be a fair predictor of intermediate-term survival in AAH patients. (Copyright © 2024. Publicado por Elsevier España, S.L.U.)
Databáze:	MEDLINE
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