Hepatitis Alcohólica: Factores Predictivos de Mortalidad
Alcoholic hepatitis is a complication of prolonged and continuous intake of alcohol affects approximately 20% of ordinary consumers. 40% of these patients die within 6 months. Objectives: To evaluate the combined value of epidemiological, clinical and laboratory parameters in the stratification of r...
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2015
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| Online adgang: | http://hdl.handle.net/10872/18248 |
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| Summary: | Alcoholic hepatitis is a complication of prolonged and continuous intake of alcohol affects approximately 20% of ordinary consumers. 40% of these patients die within 6 months. Objectives: To evaluate the combined value of epidemiological, clinical and laboratory parameters in the stratification of risk of death at 90 days. Methods: A retrospective, single-center study, conducted in patients admitted to the Gastroenterology Dr. Domingo Luciani Hospital diagnosed with alcoholic hepatitis in the period from January 1, 2010 and December 31, 2011, were collected from medical history clinical and laboratory at admission or during the first 48 hours data. Results: 39 patients mean age 50.70 ± 11.16 years, 87.17% male. They developed jaundice (87.2%) and ascites (76.9%). 46.2% had infection, the most prevalent lower urinary tract infection. According Maddrey Index 74.4% had severe alcoholic hepatitis, Glasgow Index 21 (53.8%) and Index ABIC five (12.8%). They died at 30, 60 and 90 days were, 6, 13 and 16 (15.4%, 33.3% and 41%). ROC curves were constructed to obtain a blood glucose area under the curve of 0.655 (0.875 sensitivity and specificity 0.727). 3 deaths (23.07%) with blood glucose <75 mg/dl and 10 deaths (52.63%) with glucose> 75 mg/dl, log rank test was applied to obtain a p 0.036 an ROC curve for ALT was built obtaining an area under the curve of 0676.10 patients with ALT levels <40 U / L died within 90 days compared to those with ALT >40 U / L, where one died 3 (p = 0.024). No statistically significant differences between the different indices to assess survival at 90 days were found. Conclusions: Alcoholic hepatitis is a disease with high mortality. The most common clinical manifestations are ascites, jaundice and abdominal pain; half of patients have an associated infectious process, the most frequent urinary tract infection. Glycemia and ALT levels are independent predictors of mortality at 90 days. The ABIC index tends to better stratify patients with alcoholic hepatitis. |
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