Title :

MELD 3.0 adequately predicts mortality and renal replacement therapy requirements in patients with alcohol-associated hepatitis.

Author(s) :

Díaz, Luis Antonio [Auteur]
Pontificia Universidad Católica de Chile [UC]
Fuentes-López, Eduardo [Auteur]
Pontificia Universidad Católica de Chile [UC]
Ayares, Gustavo [Auteur]
Pontificia Universidad Católica de Chile [UC]
Idalsoaga, Francisco [Auteur]
Pontificia Universidad Católica de Chile [UC]
Arnold, Jorge [Auteur]
Pontificia Universidad Católica de Chile [UC]
Valverde, María Ayala [Auteur]
Perez, Diego [Auteur]
Gómez, Jaime [Auteur]
Escarate, Rodrigo [Auteur]
Villalón, Alejandro [Auteur]
Pontificia Universidad Católica de Chile [UC]
Ramírez, Carolina A. [Auteur]
University of Western Ontario [UWO]
Hernandez-Tejero, Maria [Auteur]
Mayo Clinic [Rochester]
Zhang, Wei [Auteur]
University of Florida [Gainesville] [UF]
Qian, Steve [Auteur]
University of Florida [Gainesville] [UF]
Simonetto, Douglas A. [Auteur]
Mayo Clinic [Rochester]
Ahn, Joseph C. [Auteur]
Mayo Clinic [Rochester]
Buryska, Seth [Auteur]
Mayo Clinic [Rochester]
Dunn, Winston [Auteur]
University of Kansas Medical Center [Kansas City, KS, USA]
Mehta, Heer [Auteur]
University of Kansas Medical Center [Kansas City, KS, USA]
Agrawal, Rohit [Auteur]
University of Illinois [Chicago] [UIC]
Cabezas, Joaquin [Auteur]
Hospital Universitario Marqués de Valdecilla [Santander]
García-Carrera, Inés [Auteur]
Hospital Universitario Marqués de Valdecilla [Santander]
Cuyàs, Berta [Auteur]
Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona [UAB]
Poca, Maria [Auteur]
Hospital de la Santa Creu i Sant Pau
Soriano, German [Auteur]
Hospital de la Santa Creu i Sant Pau
Sarin, Shiv K. [Auteur]
All India Institute of Medical Sciences [New Delhi]
Maiwall, Rakhi [Auteur]
All India Institute of Medical Sciences [New Delhi]
Jalal, Prasun K. [Auteur]
Baylor College of Medicine [BCM]
Abdulsada, Saba [Auteur]
Baylor College of Medicine [BCM]
Higuera-De-La-Tijera, Fátima [Auteur]
Universidad Nacional Autónoma de México = National Autonomous University of Mexico [UNAM]
Kulkarni, Anand V. [Auteur]
University of Hyderabad
Rao, P. Nagaraja [Auteur]
University of Hyderabad
Salazar, Patricia Guerra [Auteur]
Skladaný, Lubomir [Auteur]
Slovak Medical University of Bratislava [SMU]
Bystrianska, Natalia [Auteur]
Slovak Medical University of Bratislava [SMU]
Clemente-Sanchez, Ana [Auteur]
Hospital General Universitario "Gregorio Marañón" [Madrid]
Villaseca-Gómez, Clara [Auteur]
Hospital General Universitario "Gregorio Marañón" [Madrid]
Haider, Tehseen [Auteur]
Montefiore Medical Center [Bronx, New York]
Chacko, Kristina R. [Auteur]
Montefiore Medical Center [Bronx, New York]
Romero, Gustavo A. [Auteur]
Hospital de Gastroenterología Bonorino Udaondo [Buenos Aires]
Pollarsky, Florencia D. [Auteur]
Hospital de Gastroenterología Bonorino Udaondo [Buenos Aires]
Restrepo, Juan Carlos [Auteur]
Universidad de Antioquia = University of Antioquia [Medellín, Colombia]
Castro-Sanchez, Susana [Auteur]
Universidad de Antioquia = University of Antioquia [Medellín, Colombia]
Yaquich, Pamela [Auteur]
Hospital de San Juan de Dios de Linz
Mendizabal, Manuel [Auteur]
Hospital Universitario Austral
Garrido, Maria Laura [Auteur]
Marciano, Sebastián [Auteur]
Italian Hospital of Buenos Aires
Dirchwolf, Melisa [Auteur]
Vargas, Victor [Auteur]
Vall d'Hebron University Hospital [Barcelona]
Jiménez, César [Auteur]
Vall d'Hebron University Hospital [Barcelona]
Louvet, Alexandre [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Roblero, Juan Pablo [Auteur]
Universidad de Santiago de Chile [Santiago] [USACH]
Abraldes, Juan G. [Auteur]
University of Alberta
Shah, Vijay H. [Auteur]
Mayo Clinic [Rochester]
Kamath, Patrick S. [Auteur]
Mayo Clinic [Rochester]
Arrese, Marco [Auteur]
Pontificia Universidad Católica de Chile [UC]
Singal, Ashwani K. [Auteur]
Avera Institute for Human Genetics [Sioux Falls]
Bataller, Ramon [Auteur]
Clinic Barcelona Hospital Universitari
Arab, Juan Pablo [Auteur]
University of Western Ontario [UWO]
Pontificia Universidad Católica de Chile [UC]

Journal title :

JHEP Reports Innovation in Hepatology

Abbreviated title :

JHEP Rep

Volume number :

5

Pages :

100727

Publication date :

2023-07-18

ISSN :

2589-5559

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background & Aims Model for End-Stage Liver Disease (MELD) score better predicts mortality in alcohol-associated hepatitis (AH) but could underestimate severity in women and malnourished patients. Using a global cohort, ...
Show more >Background & Aims Model for End-Stage Liver Disease (MELD) score better predicts mortality in alcohol-associated hepatitis (AH) but could underestimate severity in women and malnourished patients. Using a global cohort, we assessed the ability of the MELD 3.0 score to predict short-term mortality in AH. Methods This was a retrospective cohort study of patients admitted to hospital with AH from 2009 to 2019. The main outcome was all-cause 30-day mortality. We compared the AUC using DeLong's method and also performed a time-dependent AUC with competing risks analysis. Results A total of 2,124 patients were included from 28 centres from 10 countries on three continents (median age 47.2 ± 11.2 years, 29.9% women, 71.3% with underlying cirrhosis). The median MELD 3.0 score at admission was 25 (20–33), with an estimated survival of 73.7% at 30 days. The MELD 3.0 score had a better performance in predicting 30-day mortality (AUC:0.761, 95%CI:0.732–0.791) compared with MELD sodium (MELD-Na; AUC: 0.744, 95% CI: 0.713–0.775; p = 0.042) and Maddrey’s discriminant function (mDF) (AUC: 0.724, 95% CI: 0.691–0.757; p = 0.013). However, MELD 3.0 did not perform better than traditional MELD (AUC: 0.753, 95% CI: 0.723–0.783; p = 0.300) and Age-Bilirubin-International Normalised Ratio-Creatinine (ABIC) (AUC:0.757, 95% CI: 0.727–0.788; p = 0.765). These results were consistent in competing-risk analysis, where MELD 3.0 (AUC: 0.757, 95% CI: 0.724–0.790) predicted better 30-day mortality compared with MELD-Na (AUC: 0.739, 95% CI: 0.708–0.770; p = 0.028) and mDF (AUC:0.717, 95% CI: 0.687–0.748; p = 0.042). The MELD 3.0 score was significantly better in predicting renal replacement therapy requirements during admission compared with the other scores (AUC: 0.844, 95% CI: 0.805–0.883). Conclusions MELD 3.0 demonstrated better performance compared with MELD-Na and mDF in predicting 30-day and 90-day mortality, and was the best predictor of renal replacement therapy requirements during admission for AH. However, further prospective studies are needed to validate its extensive use in AH. Impact and implications Severe AH has high short-term mortality. The establishment of treatments and liver transplantation depends on mortality prediction. We evaluated the performance of the new MELD 3.0 score to predict short-term mortality in AH in a large global cohort. MELD 3.0 performed better in predicting 30- and 90-day mortality compared with MELD-Na and mDF, but was similar to MELD and ABIC scores. MELD 3.0 was the best predictor of renal replacement therapy requirements. Thus, further prospective studies are needed to support the wide use of MELD 3.0 in AH.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T22:25:01Z
2024-03-26T10:13:59Z