Prognostic Value of the Alcoholic Hepatitis Histologic Score in Korean Patients with Biopsy-Proven Alcoholic Hepatitis
- Author:
Dong Hyeon LEE
1
;
Youn I CHOI
;
Jeong Mo BAE
;
Mee Soo CHANG
;
Sae Kyung JOO
;
Yong Jin JUNG
;
Kook Lae E LEE
;
Byeong Gwan KIM
;
Won KIM
Author Information
- Publication Type:Original Article
- From:Gut and Liver 2020;14(5):636-643
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:The alcoholic hepatitis histologic score (AHHS) is a recently developed clinical model for predicting short-term mortality in Caucasian patients with alcoholic hepatitis (AH). The AHHS has not been extensively validated in other ethnic populations. This study validated the AHHS in a Korean patient cohort.
Methods:We conducted a pro-spective cohort study of hospitalized Korean patients with AH between January 2010 and August 2017. Histopatho-logical findings were assessed to determine the AHHS in all study subjects. Histopathological risk factors were examined by Cox regression analysis to predict overall survival (OS).Kaplan-Meier curves were plotted to assess the diagnostic performance of the AHHS.
Results:We recruited a total of 107 patients with biopsy-proven AH. None of the individual AHHS components were associated with 3-month mortality.However, the bilirubinostasis type and fibrosis severity were significantly associated with AH mortality beyond 6 months (all p<0.05, except fibrosis severity for 6-month mortality) and OS (all p<0.05). The modified AHHS classification as a binary variable (<5 vs ≥5) was also associated with OS (haz-ard ratio, 2.88; 95% confidence interval [CI], 1.50 to 5.56;p=0.002), and had higher predictive performance for OS (concordance index [C-index], 0.634; 95% CI, 0.561 to 0.707) than the original AHHS classification (mild vs moderate vs severe: C-index, 0.577; 95% CI, 0.498 to 0.656). This differ-ence was statistically significant (p=0.045).
Conclusions:In this prospective Korean AH cohort, the modified AHHS was significantly associated with OS. Therefore, the AHHS might be a useful histological prognosticator for long-term progno-sis in patients with nonsevere AH.
