Titre
Gene signature-MELD score and alcohol relapse determine long-term prognosis of patients with severe alcoholic hepatitis.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Deltenre, P.
Auteure/Auteur
Trépo, E.
Auteure/Auteur
Fujiwara, N.
Auteure/Auteur
Goossens, N.
Auteure/Auteur
Marot, A.
Auteure/Auteur
Dubois, M.
Auteure/Auteur
Spahr, L.
Auteure/Auteur
Henrion, J.
Auteure/Auteur
Moreno, C.
Auteure/Auteur
Hoshida, Y.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1478-3231
Statut éditorial
Publié
Date de publication
2020-03
Volume
40
Numéro
3
Première page
565
Dernière page/numéro d’article
570
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
The gene-signature-model for end stage liver disease (gs-MELD) score has been shown to be a strong predictor of 6-month survival in severe alcoholic hepatitis (AH). Currently, only a few studies have evaluated the long-term prognosis of patients with severe AH.
To assess the prognostic value of the gs-MELD score at 5 years in patients with severe AH.
Forty-eight consecutive patients with AH (25 males, median age 52 years [95% IC: 48-56]) were included.
The median gs-MELD score was 2.6 (95% CI: 2.2-3.0). According to the gs-MELD score, 22 patients (46%) were considered to have a poor prognosis. During a median follow-up of 29 months (95% CI: 4-43), 19 patients (40%) were abstinent and 24 patients (50%) died. At 5 years, rates of survival were 61% (95% CI: 41-81) and 26% (95% CI: 11-55) in patients with low and high gs-MELD scores (P = .001), and 81% (95% CI: 58-96) and 22% (95% CI: 10-47) in abstainers and in consumers (P < .001) respectively. In multivariable competing risk regression modelling, gs-MELD score (subdistribution hazard ratio: 5.78, 95% CI: 2.17-15.38, P < .001) and recurrent alcohol consumption (subdistribution hazard ratio: 12.18, 95% CI: 3.16-46.95, P < .001) were independently associated with 5-year mortality.
Both gs-MELD score and alcohol consumption drive AH long-term prognosis. The gs-MELD score may guide the development of molecularly targeted therapies in AH.
To assess the prognostic value of the gs-MELD score at 5 years in patients with severe AH.
Forty-eight consecutive patients with AH (25 males, median age 52 years [95% IC: 48-56]) were included.
The median gs-MELD score was 2.6 (95% CI: 2.2-3.0). According to the gs-MELD score, 22 patients (46%) were considered to have a poor prognosis. During a median follow-up of 29 months (95% CI: 4-43), 19 patients (40%) were abstinent and 24 patients (50%) died. At 5 years, rates of survival were 61% (95% CI: 41-81) and 26% (95% CI: 11-55) in patients with low and high gs-MELD scores (P = .001), and 81% (95% CI: 58-96) and 22% (95% CI: 10-47) in abstainers and in consumers (P < .001) respectively. In multivariable competing risk regression modelling, gs-MELD score (subdistribution hazard ratio: 5.78, 95% CI: 2.17-15.38, P < .001) and recurrent alcohol consumption (subdistribution hazard ratio: 12.18, 95% CI: 3.16-46.95, P < .001) were independently associated with 5-year mortality.
Both gs-MELD score and alcohol consumption drive AH long-term prognosis. The gs-MELD score may guide the development of molecularly targeted therapies in AH.
PID Serval
serval:BIB_517AEB0BAF5D
PMID
Date de création
2019-10-02T14:48:53.804Z
Date de création dans IRIS
2025-05-20T16:12:46Z