Utility of the MELD and MELD-Lactate scale in patients with severe Alcoholic Hepatitis as a predictor of severity and early mortality.
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Higuera-de la Tijera, Daniel Santana-Vargas" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Francisco I." "apellidos" => "García-Juárez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] ] ] 1 => array:3 [ "nombre" => "Irais A." "apellidos" => "Garcia-Espinosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] ] ] 2 => array:3 [ "nombre" => "Claudia L." "apellidos" => "Dorantes-Nava" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] ] ] 3 => array:3 [ "nombre" => "Jose L. Perez" "apellidos" => "Hernandez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] ] ] 4 => array:3 [ "nombre" => "María F." "apellidos" => "Higuera-de la Tijera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] ] ] 5 => array:3 [ "nombre" => "Daniel" "apellidos" => "Santana-Vargas" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0002" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Gastroenterology and Hepatology, General Hospital of Mexico, Dr Eduardo Liceaga" "etiqueta" => "1" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Research Department, General Hospital of Mexico. “Dr Eduardo Liceaga.” Mexico City, Mexico" "etiqueta" => "2" "identificador" => "aff0002" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Ethical statement</span></p><p id="para0006" class="elsevierStylePara elsevierViewall">The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.</p><p id="para0007" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Declaration of interests</span></p><p id="para0008" class="elsevierStylePara elsevierViewall">None</p><p id="para0009" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Funding</span></p><p id="para0010" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p><p id="para0011" class="elsevierStylePara elsevierViewall">General mortality<elsevierMultimedia ident="fig0001"></elsevierMultimedia></p><p id="para0012" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Figure 1.</span> Sensitivity and specificity of scales used in alcoholic hepatitis to predict mortality.</p><p id="para0013" class="elsevierStylePara elsevierViewall">28 DAYS MORTALITY<elsevierMultimedia ident="fig0002"></elsevierMultimedia></p><p id="para0014" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Figure 2</span>. Sensitivity and specificity to predict 28 days mortality.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Alcoholic Hepatitis (AH) causes acute inflammation of the liver. The prognosis depends on the recovery of the liver from rapid improvement to multi-organ failure and death. There are scales that establish the prognosis and respond to steroid in AH, based on biochemical markers, none uses lactate levels. The lactate level in a patient with hepatitis may be increased. To determine if the MELD-Lactate scale is better than MELD for predicting with greater accuracy the severity and early mortality in patients with Alcoholic Hepatitis.</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Patients</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Retrospective, retrollective and analytical study, from 2019 to 2022. The variables were obtained with laboratories upon admission, including lactate levels. The area under the curve for sensitivity and specificity was calculated for predictive scales and MELD-lactate to determine mortality at 28 and 90 days.</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Include 70 patients, 59 men (84.2%) and 11 women (15.7%), age 43.2 ±9.8 years. The mortality at 28 days was 19 patients (27.1%) and at 90 days it was 18 patients (25.7%), a total of 37 (52%). The area under the curve for MELD-Lactate was in general mortality 0.823; 0.705-0.941 (sensibility 81.8% specificity 72.4%), at 28 days 0.874; 0.780-0.968 (sensibility 88.9%; specificity 71.3%) and 90 days there was no significance, compared with MELD which was general mortality 0.741; 0.603-0.878 (sensibility 81.8% specificity 66.1%), at 28 days MELD 0.766; 0.615-.916 (sensibility 88.9% specificity 63.3%) and at 90 days there was no significance, with the rest of the scales (MELD 3.0, ABIC, Maddrey, MELD- Na and Glasgow, it was less than that of MELD-Lactate. (Figure 1,2).</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Patients with severe AH have higher mortality, either early or late. In our study we showed that the MELD-lactate scale may be a better prognostic scale for early mortality in patients with alcohol hepatitis, since it showed a better performance than all the other scales used, although these results must be confirmed in other hospital centers, we can recommend their use.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abss0001" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abss0002" "titulo" => "Materials and Patients" ] 2 => array:2 [ "identificador" => "abss0003" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abss0004" "titulo" => "Conclusions" ] ] ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0001" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr50.jpeg" "Alto" => 828 "Ancho" => 1499 "Tamanyo" => 80568 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001" "detalle" => "Unlabelled imag" "rol" => "short" ] ] ] 1 => array:6 [ "identificador" => "fig0002" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr51.jpeg" "Alto" => 1020 "Ancho" => 1500 "Tamanyo" => 90325 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0002" "detalle" => "Unlabelled imag" "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/00000029000000S2/v2_202404250742/S166526812400245X/v2_202404250742/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/16652681/00000029000000S2/v2_202404250742/S166526812400245X/v2_202404250742/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S166526812400245X?idApp=UINPBA00004N" ]
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