Prothrombin time predicts steroid response in severe alcohol‐related hepatitis

Claudia Tarli, Sergio Mannucci, Michele Vecchione, Mariangela Antonelli, Luisa Sestito, Francesco Antonio Mancarella, Alberto Tosoni, Tommaso Dionisi, Valeria Maccauro, Giovanna Di Sario, Patrizia Burra, Giacomo Germani, Antonio Gasbarrini, Giovanni Addolorato

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background and Aims: Alcohol-related hepatitis (AH) is the most severe form of acute alcohol-related liver disease. Maddrey's discriminant function >= 32 defines the severe form of AH, which is associated with a high mortality. Steroid therapy represents the main medical treatment that may reduce short-term mortality. Lille score at day 7 assesses the therapeutic response to steroid therapy. At present, no parameters able to predict the response to steroid therapy have been highlighted. The aim of the present study was to evaluate if baseline prothrombin time (BPT) could predict the response to steroid in severe AH (sAH).Methods: Patients consecutively admitted in two Italian Liver Units, from 2017 to 2022, suffering from sAH were included. Data were collected prospectively. In order to evaluate if BPT could predict steroid response, we assessed the correlation between BPT using the Lille score at day 7.Results: A total of 52 patients received steroid treatment were enrolled in the study. The response to therapy was assessed by Lille score at day 7. Responders were 34 patients (65%), non-responders 18 patients (34%). BPT significantly predicted the steroid response (p < .001). The likelihood of not responding to the steroid therapy was significantly higher in patients with higher BPT (OR = 2.954).Conclusions: BPT value predicted steroid response in patients with sAH. BPT could quickly identify non-responder patients to steroid therapy, reducing the risk of infections and it could allow the early evaluation for liver transplantation.
Lingua originaleEnglish
pagine (da-a)823-830
Numero di pagine8
RivistaLiver International
Volume44
DOI
Stato di pubblicazionePubblicato - 2024

Keywords

  • corticosteroid therapy
  • early liver transplantation
  • prothrombine time
  • severe alcohol-related hepatitis
  • steroid response

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