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AARC score determines outcomes in patients with alcohol-associated hepatitis: a multinational study

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dc.contributor.author Maiwall, R.
dc.contributor.author Pasupuleti, S.S.R.
dc.contributor.author Choudhury, A.
dc.contributor.author Kim, D.J.
dc.contributor.author Sood, A.
dc.contributor.author Goyal, O.
dc.contributor.author Midha, V.
dc.contributor.author Devarbhavi, H.
dc.contributor.author Arora, A.
dc.contributor.author Kumar, A.
dc.contributor.author Sahu, M.K.
dc.contributor.author Maharshi, S.
dc.contributor.author Duseja, A.K.
dc.contributor.author Singh, V.
dc.contributor.author Taneja, S.
dc.contributor.author Rao, P.N.
dc.contributor.author Kulkarni, A.
dc.contributor.author Ghazinian, H.
dc.contributor.author Hamid, S.
dc.contributor.author Eapen, C.E.
dc.contributor.author Goel, A.
dc.contributor.author Shreshtha, A.
dc.contributor.author Shah, S.
dc.contributor.author Hu, J.
dc.contributor.author Prasad, V.G.M.
dc.contributor.author Yuemin, N.
dc.contributor.author Shaojie, X.
dc.contributor.author Dhiman, R.K.
dc.contributor.author Chen, T.
dc.contributor.author Ning, Q.
dc.contributor.author Panackel, C.
dc.contributor.author Niriella, M.A.
dc.contributor.author Lama, T.K.
dc.contributor.author Tan, S.S.
dc.contributor.author Dokmeci, A.K.
dc.contributor.author Shukla, A.
dc.contributor.author Sharma, M.K.
dc.contributor.author Sarin, S.K.
dc.date.accessioned 2023-01-19T06:24:02Z
dc.date.available 2023-01-19T06:24:02Z
dc.date.issued 2023
dc.identifier.citation Hepatology International.2023:17(3):662-675. [Epub 2022 Dec 26.] en_US
dc.identifier.issn 1936-0533
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/25822
dc.description Indexed in MEDLINE. en_US
dc.description.abstract BACKGROUND AND AIM: Acute-on-chronic liver failure (ACLF) is a severe form of alcoholic hepatitis (SAH). We aimed to study the natural course, response to corticosteroids (CS), and the role of the Asian Pacific Association for the Study of Liver (APASL) research consortium (AARC) score in determining clinical outcomes in AH patients. METHODS: Prospectively collected data from the AARC database were analyzed. RESULTS: Of the 1249 AH patients, (aged 43.8 ± 10.6 years, 96.9% male, AARC score 9.2 ± 1.9), 38.8% died on a 90 day follow-up. Of these, 150 (12.0%) had mild-moderate AH (MAH), 65 (5.2%) had SAH and 1034 (82.8%) had ACLF. Two hundred and eleven (16.9%) patients received CS, of which 101 (47.87%) were steroid responders by day 7 of Lille's model, which was associated with improved survival [Hazard ratio (HR) 0.15, 95% CI 0.12-0.19]. AARC-ACLF grade 3 [OR 0.28, 0.14-0.55] was an independent predictor of steroid non-response and mortality [HR 3.29, 2.63-4.11]. Complications increased with degree of liver failure [AARC grade III vs. II vs I], bacterial infections [48.6% vs. 37% vs. 34.7%; p < 0.001); extrahepatic organ failure [66.9% vs. 41.8% vs. 35.4%; p < 0.001] respectively. The AARC score better discriminated 90-day mortality. Harrell's C-index was 0.72 compared to other scores. CONCLUSION: Nearly 4 of 5 patients with AH present with ACLF. Such patients have a higher risk of infections, organ failures, lower response to CS, and higher mortality. Patients with AH and ACLF with AARC grade 3 should be considered for an early liver transplant. en_US
dc.language.iso en en_US
dc.publisher Springer en_US
dc.subject A.K.I en_US
dc.subject Acute-On-Chronic Liver Failure en_US
dc.subject Hepatitis, Alcoholic en_US
dc.subject Hepatitis, Alcoholic-complications en_US
dc.subject Liver Transplantation en_US
dc.subject Liver Transplantation-adverse effects en
dc.title AARC score determines outcomes in patients with alcohol-associated hepatitis: a multinational study en_US
dc.type Article en_US


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