Spahr et al identified risk factors for short-term mortality for a patient with alcoholic steatohepatitis. These can help to identify a patient who may benefit from more aggressive management. The authors rae from the University Hospitals of Geneva.
Patient selection: alcoholic steatohepatitis, negative for sepsis
Outcome: 3-month mortality
Parameters:
(1) age in years
(2) Maddrey's score
(3) intraparenchymal cholestasis in a liver biopsy performed soon after admission
Parameter
Finding
Points
age in years
< 50 years of age
0
>= 50 years (OR 2.8)
1
Maddrey score
< 32
0
>= 32 (OR 3.9)
1
intraparenchymal cholestasis
none or mild
0
marked (OR 3.9)
1
where:
• Patients with intraparenchymal cholestasis tended to have an elevated serum total bilirubin (> 120 µmol/L; Figure 5 page 6).
total number of poor prognostic factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The risk for 3-month mortality increased with the number of risk factors present.
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