ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022
Trajectory of Serum Bilirubin Predicts Spontaneous Recovery in a Real-World Cohort of Patients With Alcoholic Hepatitis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 44 citations in OpenAlex.
- Acute-on-Chronic Liver Failure in Severe Alcohol-Associated Hepatitis: Impact on Management, Prognostication, and Urgency of Liver Transplantation.Journal of clinical medicine · 2026Article
- Early liver transplantation in alcohol-associated liver disease-Evolution of practice, patient selection, management, and outcomes.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Review
- Stratification and selection of therapies to improve survival in severe alcoholic hepatitis.World journal of hepatology · 2025Review
- Comparison Between Dynamic Models for Predicting Response to Corticosteroids in Alcohol-Associated Hepatitis: A Global Cohort Study.Alimentary pharmacology & therapeutics · 2025Article
- Alcohol-associated liver disease: Natural history, management and novel targeted therapies.Clinical and molecular hepatology · 2025Review
- Prospective study on time-to-tertiary care in alcohol-associated hepatitis: space-time coordinates as prognostic tool and therapeutic target.Alcohol and alcoholism (Oxford, Oxfordshire) · 2025Observational
- Survival Benefit From Corticosteroids in Severe Alcohol-associated Hepatitis Attributed to Clinical and Treatment Differences in a Large Multicenter Cohort.Clinical and translational gastroenterology · 2025Article
- Age added to MELD or ACLF predicts survival in patients with alcohol-associated hepatitis declined for liver transplantation.Hepatology communications · 2024Article
- Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design.Hepatology communications · 2024Article
- Improving survival in alcohol-related hepatitis: what's new?Frontline gastroenterology · 2024Review
- Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group.BMJ open gastroenterology · 2023Article
- Blood unconjugated bilirubin and tacrolimus are negative predictors of specific cellular immunity in kidney transplant recipients after SAR-CoV-2 inactivated vaccination.Scientific reports · 2023Observational
- A novel smartphone scleral-image based tool for assessing jaundice in decompensated cirrhosis patients.Journal of gastroenterology and hepatology · 2023Article
- How to manage alcohol-related liver disease: A case-based review.Frontline gastroenterology · 2023Article
- Natural History of Alcohol-Associated Liver Disease: Understanding the Changing Landscape of Pathophysiology and Patient Care.Gastroenterology · 2022Review
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
23 authors at 19 institutions in 7 countries.
Funding
Abstract
BACKGROUND AND
aimsAlcoholic hepatitis (AH) is a severe condition with poor short-term prognosis. Specific treatment with corticosteroids slightly improves short-term survival but is associated with infection and is not used in many centers. A reliable method to identify patients who will recover spontaneously will minimise the numbers of patients who experience side effects of available treatments.
methodsWe analysed the trajectory of serum bilirubin concentration over the course of hospital admissions in patients with AH to predict spontaneous survival and the need for treatment.
resultsdata from 426 patients were analysed. Based on bilirubin trajectory, patients were categorized into three groups: 'fast fallers' (bilirubin <0.8 x admission value at day 7), 'static' (bilirubin of >0.9 - <1.2 x admission value) and 'rapid risers' (bilirubin of ≥1.2 x admission bilirubin). Fast fallers had significantly better 90-day survival compared to other groups (log rank p < .001), and showed no benefit of corticosteroid therapy (OR for survival at 28 days of treatment, 0.94, 95% CI 0.06 - 8.41). These findings remained even amongst patients with severe disease based on initial DF, GAHS or MELD scores.
conclusionsWe present an intuitive method of classifying patients with AH based on the trajectory of bilirubin over the first week of admission. It is complimentary to existing scores that identify candidates for corticosteroid treatment or assess response to treatment. This method identifies a group of patients with AH who recover spontaneously and can avoid corticosteroid therapy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.