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Malnutrition is a key prognostic factor related to high mortality-rate in patients with severe alcoholic hepatitis

Fatima Higuera-de La Tijera, Alfredo Servín-caamaño, Luis Servìn-abad, José Luis Pérez-hernández

Background and aim: comparatively with European or North-American populations, severe alcoholic hepatitis has a high mortality rate in Mexican population, becoming as high as 50 to 81% in those classified as ABIC B or C; this is true even when they receive specific therapy with steroids or pentoxifylline. The aim of this study was to know which clinical factors are related to early mortality (first 30 days) in Mexican patients with severe alcoholic hepatitis.Subjects and methods: this was a retrospective cohort study that included patients with severe alcoholic hepatitis, defined by a Maddrey’s discriminant function ≥ 32, treated at a tertiary care center in a period of five years (2010 to 2015).Results: seventy-six patients were included, 72 (94.7%) were males, mean age was 43 ± 9.1 year-old, and 58 (76.3%) had also cirrhosis. According to the subjective global assessment (SGA), 38 (50%) had severe malnutrition, 22 (28.9%) were at risk of malnutrition, and 16 (21.1%) were well-nourished. At 30 days, 46 patients (60.5%) died. In the multivariate analysis, only the presence of severe malnutrition was associated with 30-day mortality: OR = 6.4; 95% CI: 1.9-22.1; p = 0.003.Conclusions: the nutritional status seems to be a cardinal prognostic factor associated with early mortality (first 30 days). Malnutrition can explain the high mortality rate observed in Mexican patients with severe alcoholic hepatitis.

Palabras Clave: alcoholic hepatitis, malnutrition, mortality, global subjective assessment, risk factors

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