Recurrent alcohol-associated hepatitis is common and is associated with increased mortality

Background:Alcohol relapse after surviving an episode of alcohol-associated hepatitis (AH) is common. However, the clinical features, risk factors and prognostic implications of recurrent AH (RAH) are not well described. Methods:A registry-based study of patients admitted to 28 Spanish hospitals for...

Descripción completa

Detalles Bibliográficos
Autores: Gratacós Ginès, Jordi, Ruz Zafra, Pilar, Celada Sendino, Miriam, Marti Carretero, Aina, Pujol, Claudia, Martín Mateos, Rosa, Echavarria, Victor, Frisancho, Luis E, Garcia, Sonia, Barreales, Monica, Tejedor Tejada, Javier, Vazquez Rodriguez, Sergio, Cañete, Nuria, Fernandez Carrillo, Carlos, Valenzuela, Maria, Marti Aguado, David, Horta, Diana, Quiñones, Marta, Bernal Monterde, Vanesa, Acosta, Silvia, Artaza, Tomas, Pinazo, Jose, Villar Lucas, Carmen, Clemente Sánchez, Ana, Badia Aranda, Ester, Giraldez Gallego, Alvaro, Rodriguez, Manuel, Sancho Bru, Pau, Cabezas, Joaquin, Ventura Cots, Meritxell, Fernandez Rodriguez, Conrado, Aguilera, Victoria, Tomé, Santiago, Bataller Alberola, Ramon, Caballeria Rovira, Joan, Pose Méndez, Elisa, REHALC Registry investigators
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2024
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/218875
Acceso en línea:https://hdl.handle.net/2445/218875
Access Level:acceso abierto
Palabra clave:Consum d'alcohol
Hepatitis
Mortalitat
Drinking of alcoholic beverages
Mortality
id ES_fdf75eed620d4b69f115242faeb3d1d8
oai_identifier_str oai:diposit.ub.edu:2445/218875
network_acronym_str ES
network_name_str España
repository_id_str
spelling Recurrent alcohol-associated hepatitis is common and is associated with increased mortalityGratacós Ginès, JordiRuz Zafra, PilarCelada Sendino, MiriamMarti Carretero, AinaPujol, ClaudiaMartín Mateos, RosaEchavarria, VictorFrisancho, Luis EGarcia, SoniaBarreales, MonicaTejedor Tejada, JavierVazquez Rodriguez, SergioCañete, NuriaFernandez Carrillo, CarlosValenzuela, MariaMarti Aguado, DavidHorta, DianaQuiñones, MartaBernal Monterde, VanesaAcosta, SilviaArtaza, TomasPinazo, JoseVillar Lucas, CarmenClemente Sánchez, AnaBadia Aranda, EsterGiraldez Gallego, AlvaroRodriguez, ManuelSancho Bru, PauCabezas, JoaquinVentura Cots, MeritxellFernandez Rodriguez, ConradoAguilera, VictoriaTomé, SantiagoBataller Alberola, RamonCaballeria Rovira, JoanPose Méndez, ElisaREHALC Registry investigatorsConsum d'alcoholHepatitisMortalitatDrinking of alcoholic beveragesHepatitisMortalityBackground:Alcohol relapse after surviving an episode of alcohol-associated hepatitis (AH) is common. However, the clinical features, risk factors and prognostic implications of recurrent AH (RAH) are not well described. Methods:A registry-based study of patients admitted to 28 Spanish hospitals for an episode of AH between 2014 and 2021. Baseline demographics and laboratory variables were collected. Risk factors for RAH were investigated using Cox regression analysis. We analyzed the severity of the index episodes of AH and compared it to that of RAH. Long-term survival was assessed by Kaplan-Meier curves and log-rank test. Results:A total of 1,118 patients were included in the analysis, 125 (11%) of whom developed RAH during follow-up (median: 17 [7-36] months). The incidence of RAH in patients resuming alcohol use was 22%. Median time to recurrence was 14 (8-29) months. Patients with RAH had more psychiatric comorbidities. Risk factors for developing RAH included age <50 years, alcohol use >10 units/day and history of liver decompensation. RAH was clinically more severe compared to first AH (higher MELD, more frequent ACLF and hepatic encephalopathy). Moreover, alcohol abstinence during follow-up was less common after RAH (18% vs 45%, p<0.001). Most importantly, long-term mortality was higher in patients who developed RAH (39% vs 21%, p=0.026) and presenting with RAH independently predicted high mortality (HR 1.55 [1.11-2.18]). Conclusions:RAH is common and has a more aggressive clinical course, including increased mortality. Patients surviving an episode of AH should undergo intense alcohol use disorder therapy to prevent RAH.Wolters Kluwer Health2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/218875Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1097/HEP.0000000000000825Hepatology, 2024, vol. 80, num. 3, p. 621-632https://doi.org/10.1097/HEP.0000000000000825(c) American Association for the Study of Liver Diseases, 2024info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2188752026-05-27T06:46:51Z
dc.title.none.fl_str_mv Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
title Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
spellingShingle Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
Gratacós Ginès, Jordi
Consum d'alcohol
Hepatitis
Mortalitat
Drinking of alcoholic beverages
Hepatitis
Mortality
title_short Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
title_full Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
title_fullStr Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
title_full_unstemmed Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
title_sort Recurrent alcohol-associated hepatitis is common and is associated with increased mortality
dc.creator.none.fl_str_mv Gratacós Ginès, Jordi
Ruz Zafra, Pilar
Celada Sendino, Miriam
Marti Carretero, Aina
Pujol, Claudia
Martín Mateos, Rosa
Echavarria, Victor
Frisancho, Luis E
Garcia, Sonia
Barreales, Monica
Tejedor Tejada, Javier
Vazquez Rodriguez, Sergio
Cañete, Nuria
Fernandez Carrillo, Carlos
Valenzuela, Maria
Marti Aguado, David
Horta, Diana
Quiñones, Marta
Bernal Monterde, Vanesa
Acosta, Silvia
Artaza, Tomas
Pinazo, Jose
Villar Lucas, Carmen
Clemente Sánchez, Ana
Badia Aranda, Ester
Giraldez Gallego, Alvaro
Rodriguez, Manuel
Sancho Bru, Pau
Cabezas, Joaquin
Ventura Cots, Meritxell
Fernandez Rodriguez, Conrado
Aguilera, Victoria
Tomé, Santiago
Bataller Alberola, Ramon
Caballeria Rovira, Joan
Pose Méndez, Elisa
REHALC Registry investigators
author Gratacós Ginès, Jordi
author_facet Gratacós Ginès, Jordi
Ruz Zafra, Pilar
Celada Sendino, Miriam
Marti Carretero, Aina
Pujol, Claudia
Martín Mateos, Rosa
Echavarria, Victor
Frisancho, Luis E
Garcia, Sonia
Barreales, Monica
Tejedor Tejada, Javier
Vazquez Rodriguez, Sergio
Cañete, Nuria
Fernandez Carrillo, Carlos
Valenzuela, Maria
Marti Aguado, David
Horta, Diana
Quiñones, Marta
Bernal Monterde, Vanesa
Acosta, Silvia
Artaza, Tomas
Pinazo, Jose
Villar Lucas, Carmen
Clemente Sánchez, Ana
Badia Aranda, Ester
Giraldez Gallego, Alvaro
Rodriguez, Manuel
Sancho Bru, Pau
Cabezas, Joaquin
Ventura Cots, Meritxell
Fernandez Rodriguez, Conrado
Aguilera, Victoria
Tomé, Santiago
Bataller Alberola, Ramon
Caballeria Rovira, Joan
Pose Méndez, Elisa
REHALC Registry investigators
author_role author
author2 Ruz Zafra, Pilar
Celada Sendino, Miriam
Marti Carretero, Aina
Pujol, Claudia
Martín Mateos, Rosa
Echavarria, Victor
Frisancho, Luis E
Garcia, Sonia
Barreales, Monica
Tejedor Tejada, Javier
Vazquez Rodriguez, Sergio
Cañete, Nuria
Fernandez Carrillo, Carlos
Valenzuela, Maria
Marti Aguado, David
Horta, Diana
Quiñones, Marta
Bernal Monterde, Vanesa
Acosta, Silvia
Artaza, Tomas
Pinazo, Jose
Villar Lucas, Carmen
Clemente Sánchez, Ana
Badia Aranda, Ester
Giraldez Gallego, Alvaro
Rodriguez, Manuel
Sancho Bru, Pau
Cabezas, Joaquin
Ventura Cots, Meritxell
Fernandez Rodriguez, Conrado
Aguilera, Victoria
Tomé, Santiago
Bataller Alberola, Ramon
Caballeria Rovira, Joan
Pose Méndez, Elisa
REHALC Registry investigators
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Consum d'alcohol
Hepatitis
Mortalitat
Drinking of alcoholic beverages
Hepatitis
Mortality
topic Consum d'alcohol
Hepatitis
Mortalitat
Drinking of alcoholic beverages
Hepatitis
Mortality
description Background:Alcohol relapse after surviving an episode of alcohol-associated hepatitis (AH) is common. However, the clinical features, risk factors and prognostic implications of recurrent AH (RAH) are not well described. Methods:A registry-based study of patients admitted to 28 Spanish hospitals for an episode of AH between 2014 and 2021. Baseline demographics and laboratory variables were collected. Risk factors for RAH were investigated using Cox regression analysis. We analyzed the severity of the index episodes of AH and compared it to that of RAH. Long-term survival was assessed by Kaplan-Meier curves and log-rank test. Results:A total of 1,118 patients were included in the analysis, 125 (11%) of whom developed RAH during follow-up (median: 17 [7-36] months). The incidence of RAH in patients resuming alcohol use was 22%. Median time to recurrence was 14 (8-29) months. Patients with RAH had more psychiatric comorbidities. Risk factors for developing RAH included age <50 years, alcohol use >10 units/day and history of liver decompensation. RAH was clinically more severe compared to first AH (higher MELD, more frequent ACLF and hepatic encephalopathy). Moreover, alcohol abstinence during follow-up was less common after RAH (18% vs 45%, p<0.001). Most importantly, long-term mortality was higher in patients who developed RAH (39% vs 21%, p=0.026) and presenting with RAH independently predicted high mortality (HR 1.55 [1.11-2.18]). Conclusions:RAH is common and has a more aggressive clinical course, including increased mortality. Patients surviving an episode of AH should undergo intense alcohol use disorder therapy to prevent RAH.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/218875
url https://hdl.handle.net/2445/218875
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1097/HEP.0000000000000825
Hepatology, 2024, vol. 80, num. 3, p. 621-632
https://doi.org/10.1097/HEP.0000000000000825
dc.rights.none.fl_str_mv (c) American Association for the Study of Liver Diseases, 2024
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) American Association for the Study of Liver Diseases, 2024
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Wolters Kluwer Health
publisher.none.fl_str_mv Wolters Kluwer Health
dc.source.none.fl_str_mv Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869425641347088384
score 15,811543

Similares en LA Referencia