Prognostic value of relative adrenal insufficiency in patients with severe alcohol-associated hepatitis-a prospective clinical study.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia Pub Date : 2024-12-12 DOI:10.1016/j.gastrohep.2024.502322

Raúl Alberto Jiménez-Castillo, Carlos Eugenio González-Martínez, Elianee María Tovar-Bojorquez, Carlos Alejandro Cortez-Hernández, Joel Omar Jaquez-Quintana, José Alberto González-González, José Gerardo González-González, Héctor Jesús Maldonado-Garza

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引用次数: 0

Abstract

Background/aims: Relative adrenal insufficiency (RAI) is frequent in patients with liver cirrhosis and affects their prognosis. Scarce data on RAI in patients with alcohol-associated hepatitis (AAH) exists. This study aimed to document the prevalence and prognostic implication of RAI in patients with severe AAH.

Patients and methods: Adults with a first episode of AAH were selected. The delta cortisol level was the difference between the serum basal cortisol and 60 minutes after ACTH stimulation. Cox proportional-hazard regression model was used for univariate analysis of prognostic factors with 95% confidence intervals. The Kaplan-Meier and log-rank tests were applied for survival analysis between patients with RAI and without RAI.

Results: Twenty-five subjects with a first episode of AAH were included. Eight (32.0%) deaths occurred in our cohort. Univariate analysis showed that presence of RAI (p = 0.049) had a significant impact on 90-day Overall Survival (OS). Serum albumin (p = 0.991), serum creatinine (p = 0.954), sodium (p = 0.986) and international normalized ratio (p = 0.073) did not show a significant impact on 90-day OS. Ninety-day overall survival for patients with RAI was 50.0% vs. 90.9% in those without RAI, (p=0.040).

Conclusions: The presence of RAI seems to be a fair predictor of intermediate-term survival in AAH patients.

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来源期刊

Gastroenterologia y hepatologia GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

1.50

自引率

10.50%

发文量

147

审稿时长

48 days

期刊介绍： Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners.