Predicting 30-day mortality risk for patients with alcohol-associated hepatitis

Date:
February 15, 2022
Source:
Mayo Clinic
Summary:
Researchers have developed a new scoring system to help health
care professionals predict the 30-day mortality risk for patients
with alcohol-associated hepatitis, and the tool appears to more
accurately identify patients at highest risk of death and those
likely to survive.



FULL STORY ==========================================================================
Mayo Clinic researchers have developed a new scoring system to help health
care professionals predict the 30-day mortality risk for patients with
alcohol- associated hepatitis, and the tool appears to more accurately
identify patients at highest risk of death and those likely to survive.


==========================================================================
The new scoring system, called the Mortality Index for Alcohol-Associated Hepatitis (MIAAH), is at least as accurate as existing models in
identifying patients with alcohol-associated hepatis who are at high
risk of death, according to results of a study published inMayo Clinic Proceedings.

"While we believe the MIAAH will be refined over time, possibly in
conjunction with an existing model, our study finds that it's a useful
tool in assessing mortality risk," says Douglas Simonetto, M.D., a
Mayo Clinic gastroenterologist and the study's senior author. "Given
the significant mortality seen in patients with alcohol-associated
hepatitis, assessing disease severity and prognosis is critical." Alcohol-associated hepatitis is an acute inflammatory process in
the liver that occurs in patients who consume excessive amounts of
alcohol. Patients with milder forms of the disease often improve with
limited treatment, but severe disease is associated with significant
short-term mortality. No pharmacologic treatments have been found to
reduce 90-day mortality in severe cases. Accurate prognostic tools are essential for clinicians to identify patients at high risk of death and determine appropriate treatment.

At least four prognostic models are available, but the Mayo research
team set out to develop a new system that more accurately predicts
30-day mortality.

Using deidentified patient health records from Mayo Clinic in Rochester
from 1998 to 2018, researchers identified 266 adult patients with a
diagnosis of alcohol-associated hepatitis. Of those patients, the 30-day mortality rate was 19.2%. The study derived several variables, such as
blood urea nitrogen and bilirubin, and developed a model scoring system
that incorporated the variables.

The MIAAH model then was used to predict outcomes for an external
validation cohort of 249 patients from health care centers at the
University of South Dakota and the University of Kansas. The model was
found to be at last as accurate as existing tools in identifying patients
at high risk of short-term mortality.

"The MIAAH also showed advantageous performance characteristics in its
ability to increasingly accurately identify patients at highest risk
of death versus those who are more likely to survive," says Camille
Kezer, M.D., a Mayo Clinic resident physician and the study's first
author. "It also has the advantage of performing well in patients,
regardless of whether they've been treated with steroids, which makes
it generalizable." Despite decades of research, treatment options
for patients with alcohol- associated hepatitis remain limited, with questionable efficacy. Prognostic models are important for determining
which treatments may have value and whether patients are responding to treatment. Modeling is also integral in determining whether patients
are candidates for a liver transplant.

"This is why a prognostic model that accurately identifies short-term
mortality risk has such value," says Dr. Simonetto. "With
this study, we set out to create a novel model with more
consistent and reliable accuracy, based on laboratory variables
and demographic data that's routinely obtained at the time of
admission. While the optimal process may include a combination of
models, the MIAAH can be an important tool in helping our patients." ========================================================================== Story Source: Materials provided by Mayo_Clinic. Original written by
Jay Furst. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Camille A. Kezer, Seth M. Buryska, Joseph C. Ahn, William
S. Harmsen,
Winston Dunn, Ashwani K. Singal, Juan P. Arab, Luis A. Di'az,
Jorge Arnold, Patrick S. Kamath, Vijay H. Shah, Douglas
A. Simonetto. The Mortality Index for Alcohol-Associated Hepatitis:
A Novel Prognostic Score. Mayo Clinic Proceedings, 2022; DOI:
10.1016/j.mayocp.2021.10.026 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220215125459.htm
--- up 10 weeks, 3 days, 7 hours, 13 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1:317/3)