Alcoholic liver disease natural history, complications and prognosis: Difference between revisions
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(/* 2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Prognostic Factors (DO NOT EDIT){{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |forma...) |
(/* 2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Prognostic Factors (DO NOT EDIT){{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |forma...) |
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| colspan="1" style="text-align:center; background:LightGreen"|[[AASLD guidelines classification scheme#Class of recommendation|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[AASLD guidelines classification scheme#Class of recommendation|Class I]] | ||
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| bgcolor="LightGreen"| '''1.''' Patients presenting with a high clinical suspicion of alcoholic hepatitis should have their risk for poor outcome stratified using the Maddrey Discriminant Function (MDF), as well as other available clinical data. Evaluating a patient's condition over time with serial calculation of the Model for End-Stage Liver Disease (MELD) score is also justified | | bgcolor="LightGreen"| '''1.''' <nowiki>"</nowiki> Patients presenting with a high clinical suspicion of alcoholic hepatitis should have their risk for poor outcome stratified using the Maddrey Discriminant Function (MDF), as well as other available clinical data. Evaluating a patient's condition over time with serial calculation of the Model for End-Stage Liver Disease (MELD) score is also justified. ([[AASLD guidelines classification scheme#Level of evidence|Level of evidence: B]]) <nowiki>"</nowiki> | ||
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Revision as of 07:33, 28 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural history, Complications and Prognosis
Complications
Alcoholic hepatitis
- Portal hypertension (ascites, variceal bleeding, hepatorenal syndrome)
- Coagulopathy
- Intractable jaundice
Cirrhosis
- Hepatocellular carcinoma
- Hepatic encephalopathy
Prognosis
In absence of steroid therapy 1 in every three patient dies.
Poor Prognostic factors
- Prolonged prothrombin time
- Serum Bilirubin >10 mg/dL
- Hepatic encephalopathy
- Azotemia
- Leukocytosis
- Unresponsive to steroid treatment
- Reversal portal flow on doppler USG
Prognostic scores
- MELD score for cirrhosis
- Glasgow alcoholic hepatitis score (age, white blood cell, blood urea nitrogen, prothrombin time ratio, and bilirubin level)
- ABIC score - age, serum bilirubin, serum creatinine
2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Prognostic Factors (DO NOT EDIT)[1]
Class I |
1. " Patients presenting with a high clinical suspicion of alcoholic hepatitis should have their risk for poor outcome stratified using the Maddrey Discriminant Function (MDF), as well as other available clinical data. Evaluating a patient's condition over time with serial calculation of the Model for End-Stage Liver Disease (MELD) score is also justified. (Level of evidence: B) " |
References
- ↑ "www.aasld.org" (PDF). Retrieved 2012-10-27.