The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis
Background and Aims: Thrombocytopenia is present in up to 76% of patients with chronic liver disease, and lower platelet counts (PCs) are associated with greater severity of portal hypertension. In this study, we assess the relationship of PC in patients with a clinical diagnosis of severe alcoholic...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572322001376 |
| _version_ | 1797988947633111040 |
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| author | Jessie A. Birnbaum Howard S. Herman Qi Gao Mordecai Koenigsberg Samuel H. Sigal |
| author_facet | Jessie A. Birnbaum Howard S. Herman Qi Gao Mordecai Koenigsberg Samuel H. Sigal |
| author_sort | Jessie A. Birnbaum |
| collection | DOAJ |
| description | Background and Aims: Thrombocytopenia is present in up to 76% of patients with chronic liver disease, and lower platelet counts (PCs) are associated with greater severity of portal hypertension. In this study, we assess the relationship of PC in patients with a clinical diagnosis of severe alcoholic hepatitis (SAH) with clinical severity and response to corticosteroid (CS) therapy. Methods: Clinical characteristics, treatment, and hospital outcomes for patients admitted with SAH were analyzed from an electronic health record system. Patients were categorized based on admission PC (k/uL) into 5 categories: <50, 50–99, 100–149, 150–199, and ≥200. Frequency of complications (acute kidney injury, ascites, and hepatic encephalopathy), length of stay, and admission to an intensive care unit were analyzed across PC categories. Characteristics of patients who did and did not receive at least 4 days of CS therapy were compared. Results: Among 159 patients, 15 (9.4%) were in the PC < 50 category, 42 (26.4%) in PC 50-99, 51 (32%) in PC 100–149, 23 (14.5%) in PC 150–199, and 28 (17.6%) in PC ≥ 200. A higher admission PC was associated with greater white blood cell count, absolute neutrophil count, and total bilirubin (P < .05). Patients with higher PC on admission were more likely to receive steroids. PC was inversely associated with Lille score at treatment day 4 (P < .05). Conclusion: A higher PC in SAH was associated with a greater inflammatory response and total bilirubin. Patients with a higher PC were more likely to receive CS and have a favorable treatment response. |
| first_indexed | 2024-04-11T08:12:20Z |
| format | Article |
| id | doaj.art-49b01fb3de24417a8f6433567d27325c |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-04-11T08:12:20Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-49b01fb3de24417a8f6433567d27325c2022-12-22T04:35:18ZengElsevierGastro Hep Advances2772-57232023-01-0121815The Prognostic Significance of the Platelet Count in Alcoholic HepatitisJessie A. Birnbaum0Howard S. Herman1Qi Gao2Mordecai Koenigsberg3Samuel H. Sigal4Albert Einstein College of Medicine, Bronx, New YorkAlbert Einstein College of Medicine, Bronx, New YorkAlbert Einstein College of Medicine, Bronx, New YorkAlbert Einstein College of Medicine, Bronx, New York; Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New YorkAlbert Einstein College of Medicine, Bronx, New York; Division of Hepatology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York; Correspondence: Address correspondence to: Samuel H. Sigal, MD, Montefiore Medical Center, 111 East 210th Street, Rosenthal Pavilion, Room 2, Bronx, New York 10467.Background and Aims: Thrombocytopenia is present in up to 76% of patients with chronic liver disease, and lower platelet counts (PCs) are associated with greater severity of portal hypertension. In this study, we assess the relationship of PC in patients with a clinical diagnosis of severe alcoholic hepatitis (SAH) with clinical severity and response to corticosteroid (CS) therapy. Methods: Clinical characteristics, treatment, and hospital outcomes for patients admitted with SAH were analyzed from an electronic health record system. Patients were categorized based on admission PC (k/uL) into 5 categories: <50, 50–99, 100–149, 150–199, and ≥200. Frequency of complications (acute kidney injury, ascites, and hepatic encephalopathy), length of stay, and admission to an intensive care unit were analyzed across PC categories. Characteristics of patients who did and did not receive at least 4 days of CS therapy were compared. Results: Among 159 patients, 15 (9.4%) were in the PC < 50 category, 42 (26.4%) in PC 50-99, 51 (32%) in PC 100–149, 23 (14.5%) in PC 150–199, and 28 (17.6%) in PC ≥ 200. A higher admission PC was associated with greater white blood cell count, absolute neutrophil count, and total bilirubin (P < .05). Patients with higher PC on admission were more likely to receive steroids. PC was inversely associated with Lille score at treatment day 4 (P < .05). Conclusion: A higher PC in SAH was associated with a greater inflammatory response and total bilirubin. Patients with a higher PC were more likely to receive CS and have a favorable treatment response.http://www.sciencedirect.com/science/article/pii/S2772572322001376Alcoholic HepatitisPlatelet CountCorticosteroidsInterleukin-6 |
| spellingShingle | Jessie A. Birnbaum Howard S. Herman Qi Gao Mordecai Koenigsberg Samuel H. Sigal The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis Gastro Hep Advances Alcoholic Hepatitis Platelet Count Corticosteroids Interleukin-6 |
| title | The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis |
| title_full | The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis |
| title_fullStr | The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis |
| title_full_unstemmed | The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis |
| title_short | The Prognostic Significance of the Platelet Count in Alcoholic Hepatitis |
| title_sort | prognostic significance of the platelet count in alcoholic hepatitis |
| topic | Alcoholic Hepatitis Platelet Count Corticosteroids Interleukin-6 |
| url | http://www.sciencedirect.com/science/article/pii/S2772572322001376 |
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