Low-grade steatosis and major changes in portal flow as new prognostic factors in steroid-treated alcoholic hepatitis

Autor: Jeanne Tran Van Nhieu, Marianne Ziol, Sylvie Hospitel, Marie-Christine Anglade, Jean-Philippe Richardet, Véronique Sitruk, Françoise Roudot-Thoraval, François Maille, Christophe Duvoux, Issam Abd-Alsamad, Isabelle Rosa, Catherine Radier, Hughes Blondon, Daniel Dhumeaux, Olivier Seror
Rok vydání: 2004
Předmět:
Zdroj: Hepatology. 40:1370-1378
ISSN: 1527-3350
0270-9139
DOI: 10.1002/hep.20475
Popis: The aim of this study was to assess the prevalence and prognostic value of major alterations of portal flow in patients with steroid-treated alcoholic hepatitis. Fifty patients with severe, histologically proven alcoholic hepatitis were enrolled. Clinical data, liver test results, and hepatic Doppler ultrasound findings were collected at inclusion and at month 2. Patients were followed for 1 year or until death. Major changes in portal flow were defined as reversed or alternating flow in the portal trunk and/or in intrahepatic portal branches. Changes in portal flow were observed in 24 (48.0%) of 50 and 17 (39.5%) of 43 patients at inclusion and month 2, respectively. Univariate analysis showed that age older than 50 years, steatosis less than 20% on initial liver biopsy, presence of major changes in portal flow, Child-Turcotte-Pugh score higher than 12, factor V level higher than 45%, and hepatofugal splenic blood flow were associated with a lower 1-year survival. Cox regression analysis showed that steatosis < 20% (relative hazard [RH] = 9.3, P = .0009) and major changes in portal flow (RH = 3.1, P = .04), were independently associated with poor survival. In conclusion, major changes in portal flow are frequent in patients with severe alcoholic hepatitis. Altered portal flow and steatosis < 20% are new prognostic factors in steroid-treated alcoholic hepatitis and must be taken into account in patient management. (HEPATOLOGY 2004;40:1370-1378).
Databáze: OpenAIRE
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