Gene signature-MELD score and alcohol relapse determine long-term prognosis of patients with severe alcoholic hepatitis.

Détails

ID Serval
serval:BIB_517AEB0BAF5D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Gene signature-MELD score and alcohol relapse determine long-term prognosis of patients with severe alcoholic hepatitis.
Périodique
Liver international
Auteur⸱e⸱s
Deltenre P., Trépo E., Fujiwara N., Goossens N., Marot A., Dubois M., Spahr L., Henrion J., Moreno C., Hoshida Y.
ISSN
1478-3231 (Electronic)
ISSN-L
1478-3223
Statut éditorial
Publié
Date de publication
03/2020
Peer-reviewed
Oui
Volume
40
Numéro
3
Pages
565-570
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
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.
Mots-clé
MELD, cirrhosis, prognosis
Pubmed
Web of science
Création de la notice
02/10/2019 16:48
Dernière modification de la notice
30/06/2021 6:34
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