P3781 - Utility of Various Prognostic Scores in Severe Alcoholic Hepatitis

Kevin Yang, MD, Nariman Hossein-Javaheri, DO, Alexander M. Carlson, DO, Naren S. Nallapeta, MBBS, Brian M. Quigley, PhD, Thomas C. Mahl, MD
University at Buffalo, Buffalo, NY

Introduction: Severe alcoholic hepatitis (SAH) is a potentially life-threatening condition associated with significant morbidity and mortality. Prognostic scores have emerged as valuable tools to assess the severity and predict the outcomes of alcoholic hepatitis (AH). We aimed to compare various scores specifically for those who received corticosteroid therapy for SAH.

Methods: This retrospective study included all consecutive patients admitted to a tertiary care center from 2020 to 2022 with SAH based on alcohol use >40g daily, recent onset of jaundice, AST/ALT ratio >1.5, and Maddrey’s discriminant function (MDF) >32. We excluded those who did not receive corticosteroid therapy due to contraindications. Scores analyzed included the Age-Bilirubin-International Normalized Ratio-Creatinine Score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), Model for End-Stage Liver Disease (MELD), MDF, and day 7 Lille Model (LM) score utilizing receiver operating characteristics (ROC) curves.

Results: 150 patients were classified as having SAH, with 24 patients not receiving corticosteroid therapy. In the steroid arm (n = 126), average age was 49.17 (SD = 10.95). This group was 69.8% male and 30.2% female, 78.6% white and 7.1% black, and the average body mass index (BMI) was 29.17 (SD = 7.84). Mean length of stay (LOS) was 14.44 days (SD = 9.56). 19.8% of the group receiving corticosteroid therapy died by 28 days and 27% by 90 days. We also looked at readmission rates for subsequent episodes of AH, which reached 54.0%. The area under ROC (AUROC) for 28-day mortality had values of 0.784 for ABIC, 0.855 for GAHS, 0.719 for MDF, 0.748 for MELD, and 0.796 for LM. The AUROC for 90-day mortality had values of 0.713 for ABIC, 0.820 for GAHS, 0.735 for MDF, 0.744 for MELD, and 0.779 for LM.

Discussion: In this retrospective study, all prognostic scores showed comparable efficacy in predicting mortality at 28 and 90 days for patients who received corticosteroid therapy for SAH. The GAHS had the largest AUROC for both mortality endpoints.


Disclosures:


Kevin Yang, MD, Nariman Hossein-Javaheri, DO, Alexander M. Carlson, DO, Naren S. Nallapeta, MBBS, Brian M. Quigley, PhD, Thomas C. Mahl, MD. P3781 - Utility of Various Prognostic Scores in Severe Alcoholic Hepatitis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.