Predictors and prognosticators of outcomes in alcoholic hepatitis: A retrospective single center study

Table 1 Demographics and clinical data

	Full sample mean (SD/%)	Steroid sub-sample mean (SD/%)
N	425	126
Age	47.97 (11.95)	49.17 (10.95)
Sex (female)	32.0	30.2
Race	White: 70.8; Black: 14.8; Other: 14.4	White: 78.6; Black: 7.1; Other: 14.3
BMI	27.68 (6.63)	29.17 (7.84)
History of cirrhosis	56.7	86.5
History of hep C	13.6	12.7
History of hep B	2.4	1.6
History of diabetes	17.2	19.0
History of hyperlipidemia	24.7	19.0
History of hypertension	63.1	61.1
History of chronic kidney disease	9.4	11.1
Length of stay (days)	10.11 (8.43)	14.44 (9.56)
Encephalopathy	34.6	52.4
GI bleeding	19.8	30.2
Acute kidney injury	22.6	32.5
Hepatorenal syndrome	8.7	17.5
Ascites	24.0	43.7
Infection	30.2	42.1
Readmission	52.0	54.0
Mortality at 28 days	11.8	19.8
Mortality at 90 days	15.3	27.0
Nutrition consult	26.6	37.3
Albumin day 1	3.55 (0.91)	3.07 (0.74)
Albumin change day 1 to day 7	No data	-0.25 (0.63)
Daily mean percent meal intake	64.93 (25.62)	55.05 (25.41)
Grams of alcohol per day	210.25 (165.97)	228.15 (174.79)
Standard drinks per day	15.01 (11.85)	16.30 (12.48)

BMI: Body mass index.

Table 2 Predictors of outcomes in alcoholic hepatitis

Factor	Encephalopathy	GI bleeding	Acute kidney injury	Hepatorenal syndrome	Ascites	Infection	Readmission	28 days mortality	90 days mortality	Length of stay
Age	NS	NS	OR = 1.40, P = 0.002 (95%CI: 1.14-1.72)	NS	OR = 1.41, P < 0.001 (95%CI: 1.15- 1.73)	NS	NS	NS	NS	B = 0.12, P = 0.001 t = 3.27 (95%CI: 0.05-0.18)
Female sex	NS	NS	NS	NS	NS	OR = 2.12, P = 0.001 (95%CI: 1.34-3.35)	NS	NS	NS	NS
Black race	OR = 0.50, P = 0.037 (95%CI: 0.26-0.96)	OR = 0.41, P = 0.048 (95%CI: 0.17-0.99)	NS	NS	NS	OR = 0.20, P < 0.001 (95%CI: 0.08-0.49)	NS	NS	NS	NS
History of cirrhosis	OR = 3.86, P < 0.001 (95%CI: 2.45-6.08)	OR = 5.83, P < 0.001 (95%CI: 3.08-10.99)	OR = 2.75, P < 0.001 (95%CI: 1.65-4.58)	OR = 15.60, P < 0.001 (95%CI: 3.69-65.86)	NA	OR = 3.15, P < 0.001 (95%CI: 1.98-5.02)	NS	OR = 10.88, P < 0.001 (95%CI: 3.81-31.05)	OR = 7.98, P < 0.001 (95%CI: 3.53-18.04)	NS
Daily alcohol intake	NS	NS	NS	NS	NS	NS	OR = 1.15, P = 0.004 (95%CI: 1.05-1.27)	NS	NS	NS
History of chronic kidney disease	NS	NS	NS	NS	NS	NS	NS	NS	NS	B = 3.90, P = 0.005 t = 2.83 (95%CI: 1.19-6.60)
Acute kidney injury	OR = 1.79, P = 0.046 (95%CI: 1.01-3.15)	OR = 2.30, P = 0.002 (95%CI: 1.36-3.93)	NA	NA	OR = 4.10, P < 0.001 (95%CI: 2.26-7.46)	OR = 1.95, P = 0.024 (95%CI: 1.09-3.48)	NS	OR = 5.16, P < 0.001 (95%CI: 2.21-12.02)	OR = 3.94, P < 0.001 (95%CI: 1.86-8.37)	NS
Hepatorenal syndrome	OR = 3.22, P = 0.009 (95%CI: 1.34-7.70)	NS	NA	NA	OR = 3.67, P = 0.004 (95%CI: = 1.51- 8.95)	OR = 2.89, P = 0.015 (95%CI: 1.23-6.79)	OR = 0.07, P < 0.001 (95%CI: 0.03- 0.28)	OR = 9.09, P < 0.001 (95%CI: 3.52-23.51)	OR = 15.17, P < 0.001 (95%CI: 5.43-42.37)	NS
Nutrition consult	NS	OR = 0.44, P = 0.013 (95%CI: 0.23-0.84)	OR = 2.03, P < 0.001 (95%CI: 1.14-3.62)	NS	NA	NS	OR = 2.49, P < 0.001 (95%CI: 1.56-3.68)	NS	NS	NS
Percentage meal intake	OR = 0.86, P < 0.001 (95%CI: 0.78-0.94)	NS	OR = 0.79, P < 0.001 (95%CI: 0.71-0.88)	OR = 0.49, P < .001 (95%CI: 0.38-0.63)	NA	OR = 0.86, P = 0.002 (95%CI: 0.78-0.94)	NS	OR = 0.50, P < 0.001 (95%CI: 0.40-0.62)	OR = 0.54, P < 0.001 (95%CI: 0.46-0.65)	NS
Albumin day 1	OR = 0.56, P < 0.001 (95%CI: 0.43-0.73)	OR = 0.36, P < 0.001 (95%CI: 0.26-0.50)	OR = 0.51, P < 0.001 (95%CI: 0.36-0.71)	OR = 0.14, P < 0.001 (95%CI: 0.05-0.34)	NA	OR = 0.47, P < 0.001 (95%CI: 0.35-0.63)	OR = 1.32, P = 0.016 (95%CI: 1.05-1.64)	OR = 0.17, P < 0.001 (95%CI: 0.08-0.37)	OR = 0.19, P < 0.001 (95%CI: 0.11-0.36)	NS

NS: Non significant; NA: Not Applicable.

Table 3 Steroid responders by the Lille model

	Responders (%)	Non-responders (%)	Mean (SD)	Min/max
LM3	84 (66.7)	42 (33.3)	0.35 (0.30)	0.00/0.98
LM4	85 (67.5)	41 (32.5)	0.35 (0.31)	0.00/0.99
LM5	86 (68.3)	40 (31.7)	0.34 (0.31)	0.00/0.99
LM6	85 (67.5)	41 (32.5)	0.34 (0.32)	0.00/0.98
LM7	81 (64.3)	45 (35.7)	0.35 (0.32)	0.00/0.98

Table 4 Agreement of Lille model scores

	LM4	LM5	LM6	LM7
LM3 (%)	k = 0.87, 98	k = 0.82, 92	k = 0.70, 78	k = 0.70, 79
LM4 (%)		k = 0.95, 99	k = 0.82, 92	k = 0.79, 89
LM5 (%)			k = 0.87, 98	k = 0.84, 95
LM6 (%)				k = 0.86, 97

Table 5 28-day and 90-day mortality of responders by the Lille model

	28 days mortality			90 days mortality
	Responders	Non-responders	Odds ratio (95%CI)	Responders	Non-responders	Odds ratio (95%CI)
LM3 (%)	11	38	5.12 (2.02-13.00)	17	48	4.55 (1.97 -10.47)
LM4 (%)	11	39	5.40 (2.15-13.74)	16	49	4.83 (2.09 -11.17)
LM5 (%)	10	40	5.70 (2.24-14.55)	16	50	5.14 (2.21 -11.96)
LM6 (%)	9	41	6.81 (2.62-17.75)	15	51	5.82 (2.48 -13.62)
LM7 (%)	7	42	9.14 (3.29-25.34)	12	53	8.11 (3.35 -19.64)

Table 6 Receiver operating characteristic curve with 95% confidence intervals

Test	28 mortality		90 days mortality
	Area under ROC curve	95%CI	Area under ROC curve	95%CI
LM3	0.771	0.676-0.866	0.743	0.649-0.837
LM4	0.778	0.685-0.871	0.756	0.663-0.849
LM5	0.791	0.703-0.880	0.770	0.680-0.860
LM6	0.809	0.727-0.891	0.809	0.727-0.891
LM7	0.802	0.718-0.886	0.785	0.698-0.872
MDF	0.719	0.614-0.824	0.735	0.640-0.831
ABIC	0.784	0.680-0.888	0.713	0.611-0.815
GAHS	0.855	0.780-0.930	0.820	0.745-0.894
MELD	0.81	0.729-0.895	0.767	0.676-0.858

ROC: Receiver operating characteristics; ABIC: Age-bilirubin-INR-creatinine; GAHS: Glasgow alcoholic hepatitis score; MELD: Model for end stage liver disease.