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Inicio Annals of Hepatology OP-5 ALCOHOL-ASSOCIATED HEPATITIS IN LATIN AMERICA: RESULTS FROM THE AH-LATIN ST...
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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OP-5 ALCOHOL-ASSOCIATED HEPATITIS IN LATIN AMERICA: RESULTS FROM THE AH-LATIN STUDY
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Luis Antonio Díaz1, Jorge Arnold1, Francisco Idalsoaga1, Gustavo Ayares1, María Ayala-Valverde2, Diego Perez2, Jaime Gomez2, Rodrigo Escarate2, Juan Pablo Roblero3, Blanca Norero4, José Antonio Velarde5, Janett Jacobo6, Jesús Varela7, Scherezada Mejía Loza8, Jacqueline Córdova8, Rita Silva9, Cristina Melo Rocha10, Roberta C. Araujo11, Gustavo Henrique Pereira12, Claudia Couto13..., Fernando Bessone14, Mario Tanno14, Gustavo Romero15, Manuel Mendizabal16, Sebastián Marciano17, Melisa Dirchwolf18, Pedro Montes19, Patricia Guerra Salazar20, Geraldine Ramos20, Juan Carlos Restrepo21, Gabriel Díaz22, Luis Guillermo Toro23, Enrique Carrera24, Brahmania Mayur25, Singal Ashwani26, Bataller Ramon27, Shah Vijay28, Kamath Patrick S.28, Marco Arrese1, Juan Pablo Arab1,25,28,29,30Ver más
1 Department of Gastroenterology, Pontifical Catholic University of Chile, Santiago, Chile
2 El Pino Hospital, Santiago, Chile
3 Gastroenterology Section, Clinic Hospital of University of Chile, Medical School of University of Chile, Santiago, Chile
4 Sótero del Río Hospital, Santiago, Chile
5 Civil Hospital of Guadalajara, Guadalajara, México
6 General Manuel Gea González Hospital, Ciudad De México, México
7 Dublán Hospital, Chihuahua, México
8 Juárez Hospital of Mexico, Mexico City, Mexico
9 Liver Transplantation Unit and the Base Hospital of the São Jose of Rio Preto Medical School, Sao Paulo, Brasil
10 Fhaj Foundation Hospital Adriano Jorge, Amazonas, Brasil
11 Clinic Hospital of Medical School of Ribeirão Preto, Ribeirão Preto, Brasil
12 Bonsucesso Federal Hospital, Rio de Janeiro, Brasil
13 Clinic Hospital of Federal University of Minas Gerais, Belo Horizonte, Brasil
14 Centenario Provincial Hospital, Santa Fe, Argentina
15 Gastroenterology Hospital " Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina
16 Austral University Hospital, Pilar, Argentina
17 Buenos Aires Italian Hospital, Buenos Aires, Argentina
18 Rosario Private Hospital, Rosario, Argentina
19 Daniel Alcides Carrión National Hospital - Callao, Bellavista, Perú
20 Bolivian-Japanese Gastroenterological Institute, Cochabamba, Bolivia
21 Pablo Tobon Uribe Hospital. Antioquia University, Medellín, Colombia
22 Valle De Lili Foundation, Cali, Colombia
23 San Vicente Hospital, Foundation Rionegro, Antioquía, Colombia
24 Eugenio Espejo Specialty Hospital, Quito, Ecuador
25 Department of Medicine, Division of Gastroenterology, Western University, London Health Sciences Center, London, Ontario, Canada
26 Department of Medicine, University of South Dakota Sanford School of Medicine, Division of Transplant Hepatology, Avera Transplant Institute, Sioux Falls, SD, United States
27 University of Pittsburgh Medical Center, PA, USA
28 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
29 Alimentiv, London, Ontario, Canada
30 Department Of Epidemiology And Biostatistics, Schulich School Of Medicine, Western University, London, Ontario, Canada
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Vol. 28. Issue S1

Abstracts of the 2022 Annual Meeting of the ALEH

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Introduction and Objectives

Severe alcohol-associated hepatitis (AH) is an entity with high morbidity and mortality; however, data in Latin America is limited. We aimed to characterize patients hospitalized for AH in a multinational cohort in Latin America.

Materials and Methods

Multicenter prospective cohort study. We included patients admitted with severe AH between 2015-2022. Sociodemographic and clinical information was recorded. The analysis included survival analysis using Kaplan-Meier curves. This study was approved by the institutional ethics committee.

Results

470 patients from 24 centers (8 countries: Mexico, Chile, Argentina, Brazil, Peru, Bolivia, Colombia, and Ecuador) were included. Age 49.8 ± 10.6 years, 85.6% of men and 45% had a previous diagnosis of cirrhosis. Median MELD at admission was 26.9 [22-32] points. 26.5% met SIRS criteria and 34.3% had an acute kidney injury (AKI) on admission. Only 36.8% of patients were treated with corticosteroids. Survival at 30 days was 75.0% (95%CI: 70.1-79.3%) and 62.8% (95%CI: 57.1-68.0%) at 90 days. A total of 191 (45.8%) patients presented infections, 31.4% at admission and 24.9% during hospitalization. The most frequent locations of community-acquired infections were respiratory (33.5%), urinary (32.1%), spontaneous bacterial peritonitis (14.9%), and skin (10.5%), while the most frequent pathogens were Escherichia coli (40%), Klebsiella pneumoniae (12%), and Enterococcus (6%). The presence of infection at admission was associated with a decreased survival at 90-days (66.9% versus 48.1%, p=0.0002). AKI at admission was also associated with decreased survival at 90-days (86.8% versus 51.3%, p<0.0001). In the long term, only 3.2% of patients have been transplanted.

Conclusions

This multicenter study shows high morbidity and mortality in patients with severe AH, which is comparable to other regions worldwide. The presence of infections and AKI at admission were frequent and were associated with higher mortality. Unfortunately, the access to liver transplantation was extremely low in our cohort.

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Figure. Cumulative survival of alcohol-associated hepatitis according to the presence of infections at admission.

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