title: The amount of alcohol consumption negatively impacts short-term mortality in Mexican patients with alcoholic hepatitis.
abstract: OBJECTIVE
  Mexicans have an increased rate of alcohol abuse and alcoholic liver disease. Factors influencing the severity of alcoholic hepatitis (AH) in Mexicans are unknown. The aims of the present study were to identify the prognostic factors of short-term mortality in Mexican patients with AH and to validate the existing prognostic models.
  
  
  METHODS
  One hundred seventy-five consecutive patients with AH were recruited from four hospital centers in Mexico. Demographic, clinical, and biochemical parameters were obtained at admission. Univariate and multivariate logistic regression analyses were used for the identification of prognostic factors. The accuracy of different models was evaluated by their area under the receiver operating characteristic (AUROC) curve and comparative risk analysis was performed using the Kaplan-Meier method.
  
  
  RESULTS
  Age, serum creatinine, serum bilirubin, leukocyte count, and alcohol consumption >120 g/day were independently associated with short-term mortality. The impact of alcohol consumption was significant among patients with severe AH (48 vs. 72% risk of death, P=0.03). The AUROC (95% confidence interval) curves for the different scores were Maddrey's discriminant function 0.79 (0.72-0.86); model for end-stage liver disease (MELD) 0.83 (0.75-0.89); Glasgow AH score 0.77 (0.70-0.84); and age-bilirubin-international normalized ratio-creatinine (ABIC) score 0.82 (0.75-0.88). The ABIC score allowed an accurate stratification into three different risk subgroups with 13%, 50%, and 81% mortality rate at 90 days (P<0.001).
  
  
  CONCLUSIONS
  The amount of alcohol consumption has a negative impact on short-term mortality among Mexicans with AH. The ABIC score is useful and comparable with MELD score for the prognostic stratification of these patients.
authors.affiliation: Liver Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBER de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Altamirano
authors.forename: Fátima
authors.initials: F
authors.lastname: Higuera-de laTijera
authors.forename: Andres
authors.initials: A
authors.lastname: Duarte-Rojo
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Martínez-Vázquez
authors.forename: Juan G
authors.initials: JG
authors.lastname: Abraldes
authors.forename: Luis Enrique
authors.initials: LE
authors.lastname: Herrera-Jiménez
authors.forename: Javier
authors.initials: J
authors.lastname: Michelena
authors.forename: Laura
authors.initials: L
authors.lastname: Zapata
authors.forename: José
authors.initials: J
authors.lastname: Perez-Hernández
authors.forename: Aldo
authors.initials: A
authors.lastname: Torre
authors.forename: José A
authors.initials: JA
authors.lastname: Gonzáles-González
authors.forename: Andres
authors.initials: A
authors.lastname: Cardenas
authors.forename: Marlene
authors.initials: M
authors.lastname: Dominguez
authors.forename: Vicente
authors.initials: V
authors.lastname: Arroyo
authors.forename: Pere
authors.initials: P
authors.lastname: Ginès
authors.forename: Juan
authors.initials: J
authors.lastname: Caballería
authors.forename: Ramón
authors.initials: R
authors.lastname: Bataller
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects*; D000704:Analysis of Variance; D019540:Area Under Curve; D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000401:mortality*; D006801:Humans; D019934:International Normalized Ratio; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D003404:Creatinine; D001663:Bilirubin