metricas
covid
Buscar en
Annals of Hepatology
Toda la web
Inicio Annals of Hepatology LILLE-4 vs. LILLE-7 to predict short-term mortality in patients with severe alco...
Información de la revista
Vol. 29. Núm. S2.
Abstracts Asociación Mexicana del Hígado (AMH) 2023
(febrero 2024)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 29. Núm. S2.
Abstracts Asociación Mexicana del Hígado (AMH) 2023
(febrero 2024)
Acceso a texto completo
LILLE-4 vs. LILLE-7 to predict short-term mortality in patients with severe alcoholic hepatitis
Visitas
222
Claudia L. Dorantes-Nava1, María F. Higuera-de la Tijera1, Alfredo Servín-Caamaño2, Gabriela Gutiérrez-Reyes3, Miguel Y. Carmona-Castillo1, Sandra Teutli-Carrion1, Ernesto J. Medina-Avalos1, José L. Pérez-Hernández1
1 Department of Gastroenterology, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City
2 Department of Internal Medicine, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City
3 Liver, Pancreas, and Motility Laboratory (HIPAM), Department of Experimental Medicine, Faculty of Medicine, Universidad Nacional Autonoma de Mexico (UNAM), Mexico City
Este artículo ha recibido
Información del artículo
Resumen
Texto completo
Descargar PDF
Estadísticas
Figuras (1)
Suplemento especial
Este artículo forma parte de:
Vol. 29. Núm S2

Abstracts Asociación Mexicana del Hígado (AMH) 2023

Más datos
Introduction and Objectives

Alcoholic hepatitis (AH) is an acute liver inflammation associated with excessive alcohol consumption. The pharmacological treatment for AH is corticosteroids. There is a study that has proposed calculating the Lille model on day 4 (Lille-4), which apparently has comparable accuracy to the Lille model calculated on day 7 (Lille-7). However, this finding has not been validated. Therefore our objective is to determine if Lille-4 is equivalent to Lille-7 in predicting 28-day mortality in patients with probable severe alcoholic hepatitis (AH) as defined by the 2016 consortium criteria sponsored by NIAAA.

Materials and Patients

Observational, prospective, ambidirectional, analytical cohort study conducted from January 2010 to April 2023. We collected clinical and biochemical variables upon admission, calculated Lille models, assessed response and 28-day mortality. Comparative analyses were performed based on survival versus mortality. Sensitivity, specificity, PPV, NPV, and accuracy of the models were calculated.

Results

A total of 327 patients were included, 297 (90.8%) being male. Mean age was 43.4±9.3 years. The 50th percentile for alcohol consumption was 320 g/day (5th-95th percentile: 100.8-662). At day 28, 207 patients (63.3%) died. Upon admission, the patients who died showed a significant difference compared to survivors in: Maddrey (90 [95%CI: 81-99] vs. 70 [95%CI:65-75]; p<0.0001); ABIC (8.8±1.8 vs. 8.1±1.3; p<0.0001); MELD (32±8 vs. 27±4; p<0.0001); MELD-Na (33±6 vs. 30±4; p<0.0001). Lille-7 model had an AUROC of 0.71 [0.65-0.77], where a value >0.45 had a sensitivity (S) of 78% and specificity (E) of 45% in predicting early mortality. Lille-4 model had an AUROC of 0.68 [0.63-0.74], where a value >0.45 had an S of 81% and E of 54% (Figure 1).

Conclusions

Lille-7 is the model with the highest accuracy, according to the obtained AUROC, for predicting early mortality in severe alcoholic hepatitis (AH). Therefore, the determination of total bilirubin should not be done prematurely (before day 7), and steroid therapy should be provided to patients for up to 7 days to classify treatment response.

Texto completo

Ethical statement

The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.

Declaration of interests

None

Funding

None

Figure 1. Area Under the Receiver Operating Characteristic Curve (AUROC) of Lille-4 and Lille-7 for predicting 28-day mortality.

Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos