Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2010; 16(19): 2435-2439
Published online May 21, 2010. doi: 10.3748/wjg.v16.i19.2435
Early mortality of alcoholic hepatitis: A review of data from placebo-controlled clinical trials
Chao-Hui Yu, Cheng-Fu Xu, Hua Ye, Lan Li, You-Ming Li
Chao-Hui Yu, Cheng-Fu Xu, Hua Ye, Lan Li, You-Ming Li, Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Li YM designed the study; Yu CH, Xu CF, Ye H and Li L collected the data; Yu CH and Xu CF analyzed the data and wrote the manuscript; Yu CH and Xu CF contributed equally to this work.
Supported by Chinese State Key Project for High Technology, No. 2006AA02A308; National Key Technology R&D Program, No. 2008BAI52B03; Science and Technology Foundation of Zhejiang Province, No. 2008C13027-1
Correspondence to: You-Ming Li, Professor, Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. xiaofu@zju.edu.cn
Telephone: +86-571-87236603 Fax: +86-571-87236611
Received: January 6, 2010
Revised: February 7, 2010
Accepted: February 14, 2010
Published online: May 21, 2010
Abstract

AIM: To investigate the early mortality of placebo-treated alcoholic hepatitis patients.

METHODS: Mortality data about alcoholic hepatitis patients who participated in randomized placebo-controlled trials were searched from PubMed, EMBASE, and Cochrane Library, extracted and analyzed.

RESULTS: A total of 661 placebo-treated patients in 19 trials were included. The overall mortality rate was 34.19% with a median observation time of 160 d (range 21-720 d). Hepatic failure, gastrointestinal bleeding and infection were the three main causes of death, accounting for 55.47%, 21.17% and 7.30% of all deaths, respectively. One-month mortality data about 324 placebo-treated alcoholic hepatitis patients in 10 trials were reported with a pooled mortality rate of 20.37%. The one-month mortality rate of patients with moderate to severe alcoholic hepatitis tended to be higher than that of general patients (22.69% vs 10.93%, P < 0.05), whereas no significant difference was observed between the patients from North America or Europe (22.43% vs 18.45%, P > 0.05), neither any difference was found between the studies published before and after 1990 (18.18% vs 21.88%, P > 0.05).

CONCLUSION: Alcoholic hepatitis is a severe liver disease with a high mortality rate, and hepatic failure, gastrointestinal bleeding and infection are the three main causes of death.

Keywords: Alcoholic hepatitis; Mortality; Placebo