Dr Duvoux and colleagues from France undertook a study in order to assess the prevalence and prognostic value of major alterations of portal flow in patients with steroid-treated alcoholic hepatitis.
The research team enrolled a total of 50 patients with severe, histologically proven alcoholic hepatitis.
The researchers collected clinical data, liver test results, and hepatic Doppler ultrasound findings at inclusion and at month 2.
The research team followed participants for 1 year or until death.
Major changes in portal flow were defined as reversed or alternating flow in the portal trunk and/or in intrahepatic portal branches.
The researchers observed changes in portal flow in 24 (48.0%) of 50 and 17 (39.5%) of 43 patients at inclusion and month 2, respectively.
|Steatosis < 20% and major changes in portal flow are independently associated with poor survival|
After univariate analysis, the researchers were able to show that a number of factors were associated with a lower 1-year survival.
Age older than 50 years,
Steatosis less than 20% on initial liver biopsy,
Presence of major changes in portal flow,
Child-Turcotte-Pugh score higher than 12,
Factor V level higher than 45%, and
Hepatofugal splenic blood flow.
Cox regression analysis showed that steatosis < 20% and major changes in portal flow, were independently associated with poor survival.
Dr Duvoux concluded, "Major changes in portal flow are frequent in patients with severe alcoholic hepatitis."
"Altered portal flow and steatosis < 20% are new prognostic factors in steroid-treated alcoholic hepatitis and must be taken into account in patient management."