![]() The Model for end-stage liver disease (MELD) score has been also shown to predict survival in several western cohorts of patients with severe alcoholic hepatitis. 3,10 DF uses the Prothombin Time (PT), a variable that is poorly standardized across different laboratories and initial validation of DF relationship to mortality is based on patient cohorts from several decades past. 7–9 By contrast, patients with a DF < 32 have short-term survival rates of 90%–100%. 3 Patients with a DF ≥32 have a poor prognosis, with one-month mortality rates of 35%–45% in absence of specific pharmacotherapy. The discriminant function (DF) introduced by Maddrey and Boitnott, has proved useful for identifying patients with poor short-term survival rates. Various models have been shown to predict short-term prognosis in alcoholic hepatitis patients. 6 Consequently, the earlier identification of subset of patients with significant disease who will not improve with symptomatic therapy is necessary for potentially beneficial treatments to be provided. 3,5 Recently a provocative study clearly demonstrates the short-term survival benefit of liver transplantation for severe AH not responding to medical therapy. 4 Pharmacological therapies including corticosteroids and pentoxifylline need to be considered for patients with more severe disease to improve prognosis. 2,3 Although AH is considered as acute form of liver injury but nearly 50% of patients with AH have established cirrhosis at the time of clinical presentation. The prognosis among patients with alcoholic hepatitis can vary dramatically and mortality exceeding 50% in some case. 1 Chronic alcohol abuse can result in a spectrum of liver injury that ranges from mild fatty infiltration to alcoholic hepatitis (AH), cirrhosis and hepatocellular carcinoma (HCC). Alcohol is a true hepatotoxin, which contributes to majority of liver disease related deaths across the world.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |