ROCHESTER, Minnesota: A recent study (Kezer et al., 2022) published online in the Mayo Clinic Proceedings revealed a novel scoring system that can assist in identifying people with alcohol-associated hepatitis (AH) who are at high risk of short-term mortality.
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A new scoring system, named Mortality Index for Alcohol-Associated Hepatitis (MIAAH) is developed by Mayo Clinic researchers to assist health care workers in predicting the 30-day mortality risk for AH patients.
Despite decades of research, therapy options for AH patients are limited and efficacy is unknown. Prognostic models are crucial for identifying which treatments are effective and how patients respond to them. Modeling is also helpful in identifying whether or not a patient is a good candidate for a liver transplant.
Researchers identified adult AH patients using deidentified patient health information from Mayo Clinic in Rochester from 1998 to 2018. MIAAH was developed using multivariate logistic regression. A multicenter retrospective cohort was used to perform an external validation of this score.
The 30-day mortality rate in the derivation cohort of 266 patients was 19.2%. In multivariate analysis, age (P=0.002), blood urea nitrogen (P=0.003), albumin (P=0.01), bilirubin (P=0.02), and the international normalized ratio (P=0.001) were all found to be significantly associated with mortality. The C-statistic for the MIAAH model including these factors was 0.86. MIAAH had the highest concordance, a statistically significant difference when compared to existing prognostic models (Maddrey Discriminant Function and Model for End-Stage Liver Disease). The C-statistic for MIAAH reduced to 0.73 in the validation cohort of 249 patients; the model outperformed the Maddrey Discriminant Function but not the Model for End-Stage Liver Disease.
The study concluded that MIAAH can accurately identify individuals at the highest risk of death and those who are likely to survive. Camille Kezer, the first author said, “It also has the advantage of performing well in patients, regardless of whether they’ve been treated with steroids, which makes it generalizable.”
Read more at http://www.worksure.org/services/clinical-education-management/
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