■严重的酒精性肝炎(SAH)是一种严重的疾病,急性肾损伤(AKI)的存在进一步危及患者的生存。然而,AKI对SAH生存的影响尚未在亚洲这一地区进行评估.
■这项研究是对胃肠病科住院的连续酒精相关性肝病(ALD)患者进行的,SCB医学院,Cuttack,印度,2016年10月至2018年12月。在诊断SAH(mDF评分≥32)时,人口统计学,临床,并记录实验室参数,比较有和无AKI患者的生存率(AKIN标准).此外,在存在和不存在AKI的情况下,比较了由其他标准和预后模型定义的SAH患者的生存率.
■309(70.71%)ALD患者患有SAH,其中201例(65%)患有AKI。SAH合并AKI患者总白细胞计数较高,总胆红素,血清肌酐,血清尿素,INR,MELD(UNOS),MELD(Na+),CTP评分,mDF分数,格拉斯哥得分,ABIC得分,根据EASL-CLIF联盟标准,急性肝衰竭(ACLF)的患病率增加(P<0.001)。Further,他们延长了住院时间,住院期间死亡人数增加,在28天以及90天(P<0.001)。在SAH中也观察到生存率的显着差异(根据MELD,ABIC,和GAHS标准)高于AKI标记截止值的患者。
■超过三分之二的ALD患者患有SAH,大约三分之二的人患有AKI。SAH和AKI患者的ACLF患病率增加,住院时间更长,住院期间28天和90天的死亡率增加。
■SAH是一种危急情况,AKI的存在会对其生存产生负面影响。因此,早期发现SAH和AKI,以及尽早开始治疗,对更好的生存至关重要。我们在印度东部沿海地区进行的研究首次证明了ALD患者中SAH的患病率以及该地区SAH患者中AKI的患病率。这些知识将有助于管理来自世界该地区的这些患者。
UNASSIGNED: Severe alcoholic hepatitis (SAH) is a grave condition, and the presence of acute kidney injury (AKI) further jeopardizes patient survival. However, the impact of AKI on survival in SAH has not been assessed from this region of Asia.
UNASSIGNED: This study was conducted on consecutive alcohol-associated liver disease (ALD) patients hospitalized in Gastroenterology Department, SCB Medical College, Cuttack, India, between October 2016 and December 2018. On diagnosis of SAH (mDF score ≥32), demographic, clinical, and laboratory parameters were recorded, and survival was compared between patients with and without AKI (AKIN criteria). In addition, survival was compared among SAH patients defined by other criteria and prognostic models in the presence and absence of AKI.
UNASSIGNED: 309 (70.71%) of ALD patients had SAH, and 201 (65%) of them had AKI. SAH patients with AKI had higher total leucocyte count, total bilirubin, serum creatinine, serum urea, INR, MELD (UNOS), MELD (Na+), CTP score, mDF score, Glasgow score, ABIC score, and increased prevalence of acute on chronic liver failure (ACLF) as per EASL-CLIF Consortium criteria (P < 0.001). Further, they had prolonged hospital stay, and increased death during hospitalization, at 28 days as well as 90 days (P < 0.001). Significant differences in survival were also seen in SAH (as per MELD, ABIC, and GAHS criteria) patients above the marked cut offs in respect to AKI.
UNASSIGNED: Over two-thirds of ALD patients had SAH, and about two-thirds had AKI. Patients with SAH and AKI had an increased prevalence of ACLF, longer hospital stay, and increased mortality during hospitalization at 28 days and 90 days.
UNASSIGNED: SAH is a critical condition, and the presence of AKI negatively affects their survival. Hence, early identification of SAH and AKI, as well as early initiation of treatment, is crucial for better survival. Our study from the coastal part of eastern India is the first to demonstrate the prevalence of SAH among patients with ALD along with the prevalence of AKI among SAH patients in this region. This knowledge will be helpful in managing these patients from this region of world.