Abstract
Glucocorticosteroids for people with alcoholic hepatitis.
Highlights
Alcoholic hepatitis is a form of alcoholic liver disease, characterised by steatosis, necroinflammation, fibrosis, and potential complications to the liver disease
We considered trials with adult participants diagnosed with alcoholic hepatitis, which could have been established through clinical or biochemical diagnostic criteria or both
We presented the results of dichotomous outcomes as risk ratios (RR) and those of the continuous outcomes as mean difference (MD)
Summary
Alcoholic hepatitis is a form of alcoholic liver disease, characterised by steatosis, necroinflammation, fibrosis, and potential complications to the liver disease. Alcoholic hepatitis can be resolved if people abstain from drinking, but the risk of death will depend on the severity of the liver damage and abstinence from alcohol. Several composite prognostic scores exist to distinguish people with poor prognosis from those who can become abstinent, instituting supportive care, until recovery is achieved Some of these scores, designed to predict mortality, are Maddrey’s discriminant function (Maddrey 1978), the model of end-stage liver disease (MELD) score (Dunn 2005), the Glasgow alcoholic hepatitis score (Forrest 2005), and the age, bilirubin, international normalised ratio, creatinine (ABIC) score (Dominguez 2008). A Lille Model score greater than 0.45, calculated after seven days of treatment with prednisolone, means failure to respond to treatment and predicts a six-month mortality of about 75% (Lefkowitch 2005)
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