The Glasgow alcoholic hepatitis score identifies patients who may benefit from corticosteroids
| Autor: | N C Fisher, Stephen Stewart, Christopher P. Day, Ewan Forrest, Geoffrey Haydon, Ye Htun Oo, John O'Grady, M Phillips, A J Morris |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Adult
medicine.medical_specialty medicine.drug_class Alcoholic hepatitis Severity of Illness Index Pharmacological treatment Internal medicine Severity of illness Medicine Humans Glucocorticoids Royaume uni Survival analysis Hepatitis business.industry Hepatitis Alcoholic Liver Disease Patient Selection Gastroenterology Middle Aged medicine.disease Prognosis Survival Analysis Predictive factor Surgery Treatment Outcome Corticosteroid business |
| Popis: | Introduction: There is no consensus on the pharmacological treatment of alcoholic hepatitis. The Glasgow Alcoholic Hepatitis Score (GAHS) has been shown to be more accurate than the modified Maddrey9s discriminant function (mDF) in the prediction of outcome from alcoholic hepatitis. We aimed to see if the GAHS was able to identify those patients who would benefit from corticosteroids. Methods: We reviewed 225 patients with an mDF greater than or equal to 32 from five hospital centres in the United Kingdom. Patients9 survival relative to the GAHS and the use of corticosteroids was recorded. Results: 144 patients with an mDF greater than or equal to 32 (64%) also had a GAHS greater than or equal to 9. There was no difference in survival between untreated or corticosteroid-treated patients for those with a GAHS less than 9. For patients with a GAHS greater than or equal to 9 the 28 Day survival for untreated and corticosteroid-treated patients was 52% and 78% (p=0.002), and 84 Day survival 38% and 59% (p=0.02) respectively. Conclusions: Amongst patients with an mDF greater than or equal to 32, there was no appreciable benefit from treatment with corticosteroids amongst patients with a GAHS less than 9. Patients with a GAHS greater than or equal to 9 have an extremely poor prognosis if they are not treated with corticosteroids, or if such treatment is contra-indicated. |
| Databáze: | OpenAIRE |
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