title: Survival and prognostic factors in patients with severe alcoholic hepatitis treated with prednisolone.
abstract: OBJECTIVE
  Corticosteroids have been shown to significantly decrease short-term mortality in patients with severe alcoholic hepatitis. However, independent factors associated with a favorable outcome and long-term survival are unknown. The aim of this study was to examine prognostic factors and long-term survival in patients with biopsy-proven severe alcoholic hepatitis.
  
  
  METHODS
  Of 183 patients studied, 61 had been randomized in a previous trial; 32 of them were treated with prednisolone (group I) and 29 were not treated (group II); 61 were treated from the end of this randomized trial (group III); and 61 were simulated (group IV).
  
  
  RESULTS
  At 1 year, survival in group I (69%; confidence interval [CI], 57%-81%) and group III (71%; CI, 55%-87%) was better than in the nontreated groups (group II, 41%; CI, 23%-59%; P = 0.01) (group IV, 50%; CI, 37%-63%; P = 0.05). At 2 years, survival was not significantly different. Treated patients with marked liver polymorphonuclear infiltrate had better 1-year survival (76%; CI, 64%-88%) than the others (53%; CI, 35%-71%; P = 0.05). Treated patients with polymorphonuclear counts of > 5500/mm3 had better 1-year survival (77%; CI, 65%-89%) than the others (40%; CI, 14%-66%; P = 0.003). In the 93 treated patients, liver polymorphonuclear infiltrate (P < 0.03) and polymorphonuclear count (P < 0.001) were independently correlated with 1-year survival.
  
  
  CONCLUSIONS
  Prednisolone reduced mortality by at least 1 year. Liver polymorphonuclear infiltrate and polymorphonuclear count were independent prognostic factors.
authors.affiliation: Service des Traitements Ambulatoires des Maladies Alcooliques, Hôpital Beaujon, Clichy, France.
authors.forename: P
authors.initials: P
authors.lastname: Mathurin
authors.forename: V
authors.initials: V
authors.lastname: Duchatelle
authors.forename: M J
authors.initials: MJ
authors.lastname: Ramond
authors.forename: C
authors.initials: C
authors.lastname: Degott
authors.forename: P
authors.initials: P
authors.lastname: Bedossa
authors.forename: S
authors.initials: S
authors.lastname: Erlinger
authors.forename: J P
authors.initials: JP
authors.lastname: Benhamou
authors.forename: J C
authors.initials: JC
authors.lastname: Chaput
authors.forename: B
authors.initials: B
authors.lastname: Rueff
authors.forename: T
authors.initials: T
authors.lastname: Poynard
mesh_terms: D005260:Female; D006519:Hepatitis, Alcoholic / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007958:Leukocyte Count; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D009504:Neutrophils / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone