Nonalcoholic steatohepatitis--a long-term follow-up study: comparison with alcoholic hepatitis in ambulatory and hospitalized patients.
A previous publication analyzed the clinicopathological characteristics of 105 patients with steatohepatitis: 32 nonalcoholic, 21 ambulatory alcoholics, and 52 hospitalized alcoholics; we now report an up to 12-year follow-up (mean 5.9 +/- 4.7). Between 1988 and 1993, all patients with a histological diagnosis of steatohepatitis were included; necrosis, inflammation, Mallory bodies, and fibrosis were graded. Complete follow-up data were obtained in 78%. Survival curves were similar between nonalcoholic and ambulatory alcoholics; they were, however, better in nonalcoholic than hospitalized alcoholics (P < 0.0001), and in ambulatory relative to hospitalized (P = 0.0001) alcoholics. Nonalcoholics had a better prognosis than the combined alcoholic groups (P = 0.001). Patients with moderate to severe Mallory bodies and severe fibrosis had a significantly worse survival (P < 0.01), whereas severity of hepatocellular damage and neutrophil or mononuclear infiltration had no significant impact. In conclusion, alcoholic patients as a whole had a worse prognosis, yet the ambulatory subgroup had a prognosis similar to nonalcoholic patients.
Cortez-Pinto
Helena
H
Department of Medicine 2, Center of Nutrition and Metabolism FMUL, IMM, University Hospital of Santa Maria, Lisbon, Portugal. hlcortezpinto@netcabo.pt
Baptista
Amélia
A
Camilo
Maria Ermelinda
ME
De Moura
Miguel Carneiro
MC
D005234:Fatty Liver / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005235:Fatty Liver, Alcoholic / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006505:Hepatitis / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007297:Inpatients; D008103:Liver Cirrhosis / Q000209:etiology; D008297:Male; D010045:Outpatients; D011379:Prognosis; D016019:Survival Analysis