Early mortality of alcoholic hepatitis: a review of data from placebo-controlled clinical trials.
OBJECTIVE
To investigate the early mortality of placebo-treated alcoholic hepatitis patients.


METHODS
Mortality data about alcoholic hepatitis patients who participated in randomized placebo-controlled trials were searched from PubMed, EMBASE, and Cochrane Library, extracted and analyzed.


RESULTS
A total of 661 placebo-treated patients in 19 trials were included. The overall mortality rate was 34.19% with a median observation time of 160 d (range 21-720 d). Hepatic failure, gastrointestinal bleeding and infection were the three main causes of death, accounting for 55.47%, 21.17% and 7.30% of all deaths, respectively. One-month mortality data about 324 placebo-treated alcoholic hepatitis patients in 10 trials were reported with a pooled mortality rate of 20.37%. The one-month mortality rate of patients with moderate to severe alcoholic hepatitis tended to be higher than that of general patients (22.69% vs 10.93%, P < 0.05), whereas no significant difference was observed between the patients from North America or Europe (22.43% vs 18.45%, P > 0.05), neither any difference was found between the studies published before and after 1990 (18.18% vs 21.88%, P > 0.05).


CONCLUSIONS
Alcoholic hepatitis is a severe liver disease with a high mortality rate, and hepatic failure, gastrointestinal bleeding and infection are the three main causes of death.
Yu
Chao-Hui
CH
Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
Xu
Cheng-Fu
CF
Ye
Hua
H
Li
Lan
L
Li
You-Ming
YM
D000328:Adult; D016009:Chi-Square Distribution; D003141:Communicable Diseases / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000401:mortality* / Q000628:therapy; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015990:Placebo Effect; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013997:Time Factors