2. Systemic inflammatory response predicts organ failure and mortality in alcoholic hepatitis

Abstract

Background and Aims: Severe Alcoholic hepatitis (AH) can lead to SIRS due to cytokine overplay which could predispose to MOF and death. We aim to estimate the predictive accuracy of Day1 SIRS in determining MOF in patients with severe AH. We also aim to estimate the predictive accuracy of Day1 SIRS in determining the 30day mortality in patients with severe AH. Methods: Census type of study conducted at MCH, Trivandrum. Sample size was calculated as 62 patients. Cases with severe AH (DF ≥ 32) were included. Patients with HCC, overt sepsis, other causes of hepatitis, hepatotoxic drugs, coexistent CKD were excluded. Day 1 SIRS score in all patients with severe AH was taken and its relation with complications and mortality was studied and followed up for 1m to look for morbidity and mortality. Results: D1 SIRS could predict development of renal failure and MOF in patients with severe AH with sensitivity of 100% and lower specificity. D1 SIRS could predict 30 day mortality with sensitivity of 100% however with a lower specificity. However, higher D1 scores of SIRS were found to have higher sensitivity and specificity in predicting both the development of MOF and 30 d mortality. Conclusions: D1 SIRS can be used to predict development of renal failure and MOF in patients with severe AH with very high sensitivity. Therefore D1 SIRS can be used as a screening tool to stratify patients with severe AH and facilitate early referral, ICU admissions, thereby reducing adverse outcomes. The authors have none to declare.