The Impact of Previous Acute Decompensation on the Long-Term Prognosis of Alcoholic Hepatitis in Cirrhotic Patients
- 주제(키워드) alcoholic hepatitis , liver cirrhosis , acute decompensation , survival , mortality
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Yoon, Eileen L.] Inje Univ, Coll Med, Dept Internal Med, Seoul 01757, South Korea; [Kim, Tae Yeob] New Hope Internal Med Clin, Dept Internal Med, Seoul 03113, South Korea; [Song, Do Seon; Kim, Hee Yeon; Kim, Chang Wook] Catholic Univ Korea, Dept Internal Med, Seoul 06591, South Korea; [Jung, Young Kul] Korea Univ, Dept Internal Med, Seoul 02841, South Korea; [Sinn, Dong Hyun] Samsung Med Ctr, Dept Internal Med, Seoul 06531, South Korea; [Jang, Jae Young; Jeong, Soung Won] Soonchunhyang Univ, Dept Internal Med, Seoul 04401, South Korea; [Kim, Moon Young; Baik, Soon Koo] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Wonju 26426, South Korea; [Kim, Sang Gyune] Soonchunhyang Univ, Dept Internal Med, Bucheon 14584, South Korea; [Suk, Ki Tae; Kim, Dong Joon] Hallym Univ, Inst Liver & Digest Dis, Coll Med, Dept Internal Med, Chunchon 24253, South Korea; [Han, Byung Hoon] Kosin Univ, Coll Med, Dept Internal Med, Busan, South Korea; [Lee, Byung Seok] Chungnam Natl Univ, Sch Med, Dept Internal Med, Daejeon, South Korea; [Lee, Chang Hyeong] Catholic Univ, Dept Internal Med, Daegu Sch Med, Daegu, South Korea; [Chae, Hee Bok] Chungbuk Natl Univ, Coll Med, Dept Internal Med, Cheongju, South Korea; [Chae, Hee Bok] Chungbuk Natl Univ, Med Res Inst, Cheongju, South Korea; [Kwon, Hyeok Choon; Nam, Seong Woo] Natl Med Ctr, Dept Internal Med, Seoul, South Korea; [Lee, Heon Ju] Yeungnam Univ, Dept Internal Med, Coll Med, Daegu, South Korea; [Kim, Hyoung Su] Hallym Univ, Kangdong Sacred Heart Hosp, Dept Internal Med, Seoul, South Korea; [Cho, Hyun Chin] Gyeongsang Natl Univ, Sch Med, Dept Internal Med, Jinju, South Korea; [Cho, Hyun Chin] Gyeongsang Natl Univ, Sch Med, Inst Hlth Sci, Jinju, South Korea; [Yim, Hyung Joon] Korea Univ, Dept Internal Med, Ansan Hosp, Ansan, South Korea; [Kim, Jeong Han; Choe, Won Hyeok] Konkuk Univ, Sch Med, Dept Internal Med, Seoul, South Korea; [Suh, Jeong Ill] Dongguk Univ, Dept Internal Med, Gyeongju Hosp, Gyeongju, South Korea; [Yang, Jin Mo] Catholic Univ Korea, Coll Med, Dept Internal Med, Seoul, South Korea; [Sohn, Joo Hyun] Hanyang Univ, Dept Internal Med, Guri Hosp, Guri, South Korea; [Lee, Sang Soo] Gyeongsang Natl Univ, Changwon Hosp, Dept Internal Med, Chang Won, South Korea; [Park, Seung Ha] Inje Univ, Coll Med, Dept Internal Med, Haeundae Paik Hosp, Busan, South Korea; [Kim, Sung Eun] Hallym Univ, Sacred Heart Hosp, Dept Internal Med, Anyang, South Korea; [Kim, Tae Hun] Ewha Womans Univ, Sch Med, Dept Internal Med, Seoul, South Korea; [Kim, Young Seok] Soonchunhyang Univ, Bucheon Hosp, Dept Internal Med, Bucheon, South Korea
- 등재 SCIE, SCOPUS
- OA유형 gold, Green Published
- 발행기관 MDPI
- 발행년도 2019
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000166094
- 본문언어 영어
- Published As http://dx.doi.org/10.3390/jcm8101600
- PubMed https://pubmed.ncbi.nlm.nih.gov/31623316
초록/요약
Recurrent episodes of liver injury may either waste hepatic reserve or induce tolerance to further injury. We aimed to investigate whether the previous acute decompensation (AD) in liver cirrhosis (LC) affects the long-term transplant-free survival of patients with alcoholic hepatitis (AH). The survival data of 894 alcoholic LC cohort who had been admitted with acute deterioration in 21 academic hospitals in Korea were prospectively followed up. Enrolled patients were divided into three groups: Group 1, without AH; group 2, with nonsevere AH; and group 3, with severe AH. Although the baseline liver function was not different between the groups with or without previous AD, it was a significant predictor of poor long-term outcomes. The presence of previous AD negatively affected long-term overall survival (HR 1.62, 95% C.I. 1.20-2.18, p = 0.002) in groups 1 and 2 as a whole, independent of the Model for End-stage Liver Disease score. The three-month conditional survival was significantly worse in group 3 for up to 12 months in the presence of previous AD (p < 0.05). We concluded that not only the severity of AH, but also the prior AD is an important predictor of long-term outcomes in alcoholic LC patients with acute deterioration.
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