The 5-year mortality of patients with alcoholic hepatitis and an mDF <32 is nearly 50%, suggests a new study by Degré and colleagues, published in the Journal of Hepatology.

Alcoholic hepatitis and a modified Maddreys discriminant function (mDF) <32 are associated with a low risk of short-term mortality, but the long-term outcomes still need to be investigated further. In the present study, the 5-year survival rates were assessed in these patients. Investigators also aimed to determine the predictors of long-term prognosis in these patients.

Patients hospitalized for hepatic decompensation with histological findings of steatohepatitis and mDF <32 were analyzed in this study.

Among the 121 patients included in the study, 64% were male. The mean age of the patients was 51.5 ± 10.3 years and cirrhosis was present in 84%.

The study results were as follows:

• Median model for end-stage liver disease score was 14 and the mDF score was 19.
• About 30% of the patients continued to remain abstinent over follow-up.
• Survival rates at 1, 6, 12, 24, and 60 months were about 96.7%, 90.1%, 80.8%, 69.9%, and 50.7%, respectively.
• About 80% of deaths were related to the liver.
• A multivariable analysis suggested that encephalopathy at baseline and alcohol abstinence predicted 5-year survival.
• The 5-year survival rate for those without encephalopathy at baseline was around 60% and for those with encephalopathy at baseline was about 29.7%.
• The 5-year survival rate of abstinent patients was about 74.0% and that of non-abstinent patients was about 40.9%.

Presence of hepatic encephalopathy at baseline and lack of alcohol abstinence tend to harm long-term prognosis.

Source: DegréD, Stauber RE, Englebert G, et al.Long-term outcomes in patients with decompensated alcohol-related liver disease, steatohepatitis and Maddreys discriminant function <32. J Hepatol. 2020;72(4):636-42.