ArticleHepatology international2023
AARC score determines outcomes in patients with alcohol-associated hepatitis: a multinational study.
Article in Hepatology international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Prognostic Utility of Systemic Inflammatory Response Syndrome (SIRS) Criteria in Acute Alcohol-Associated Hepatitis.Digestive diseases and sciences · 2026Article
- Acute-on-chronic liver failure: pathophysiological mechanisms and clinical management.Nature reviews. Gastroenterology & hepatology · 2026Review
- Estimating the ideal pretransplant waiting time for living donor liver transplantation in acute-on-chronic liver failure: a retrospective study.Clinical transplantation and research · 2026Article
- Diabetes mellitus is linked to higher mortality in alcohol-related acute-on-chronic liver failure.Hepatology international · 2026Observational
- Association Between Nucleated Red Blood Cell Counts and the Mortality in Patients With Liver Diseases: An Analysis of the MIMIC-IV Database.Journal of cellular and molecular medicine · 2025Article
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- From prognostication to therapeutics: Four key questions to accelerate the development of therapeutics for patients with acute-on-chronic liver failure.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- Asia-Pacific association for study of liver guidelines on management of ascites in liver disease.Hepatology international · 2023Article
- Liver Transplantation in Chronic Liver Disease and Acute on Chronic Liver Failure- Indication, Timing and Practices.Journal of clinical and experimental hepatologyReview
- Prognostic Value of Neutrophil-to-lymphocyte Ratio in Patients with Acute-on-chronic Liver Failure in Comparison with Standard Scores: A Cross-sectional Observational Study from a Tertiary Care Hospital in South India.Euroasian journal of hepato-gastroenterologyArticle
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Authors and funding
38 authors.
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Abstract
BACKGROUND AND
aimAcute-on-chronic liver failure (ACLF) is a severe form of alcoholic hepatitis (SAH). We aimed to study the natural course, response to corticosteroids (CS), and the role of the Asian Pacific Association for the Study of Liver (APASL) research consortium (AARC) score in determining clinical outcomes in AH patients.
methodsProspectively collected data from the AARC database were analyzed.
resultsOf the 1249 AH patients, (aged 43.8 ± 10.6 years, 96.9% male, AARC score 9.2 ± 1.9), 38.8% died on a 90 day follow-up. Of these, 150 (12.0%) had mild-moderate AH (MAH), 65 (5.2%) had SAH and 1034 (82.8%) had ACLF. Two hundred and eleven (16.9%) patients received CS, of which 101 (47.87%) were steroid responders by day 7 of Lille's model, which was associated with improved survival [Hazard ratio (HR) 0.15, 95% CI 0.12-0.19]. AARC-ACLF grade 3 [OR 0.28, 0.14-0.55] was an independent predictor of steroid non-response and mortality [HR 3.29, 2.63-4.11]. Complications increased with degree of liver failure [AARC grade III vs. II vs I], bacterial infections [48.6% vs. 37% vs. 34.7%; p < 0.001); extrahepatic organ failure [66.9% vs. 41.8% vs. 35.4%; p < 0.001] respectively. The AARC score better discriminated 90-day mortality. Harrell's C-index was 0.72 compared to other scores.
conclusionNearly 4 of 5 patients with AH present with ACLF. Such patients have a higher risk of infections, organ failures, lower response to CS, and higher mortality. Patients with AH and ACLF with AARC grade 3 should be considered for an early liver transplant.
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