Clinical Features,Prognosis And Predictive Model Analysis Of Severe Alcoholic Hepatitis

Objective:To study the clinical characteristics of patients with SAH,analyze the independent risk factors affecting short-term prognosis,and compare the prognostic value of MDF,MELD,ABIC,GAHs,CLIF-SOFA,CTP and other scoring models.Methods:A retrospective study was performed on102 patients with SAH admitted to the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2022,and the data of patients were collected within 24 hours after diagnosis of SAH,and the survival of patients was followed up for 28 days and 90 days.According to the results of follow-up,they were divided into survival and death groups;According to liver failure,it was divided into non-ACLF group and ACLF group;Results:NEU%,TBil,WBC,NEU,BUN,CR,PT,INR,PCT,NCR,and NLR were higher in the death group than in the survival group,and the activity of Na⁺,ALB and PT was lower than that in the survival group.The ACLF group had higher WBC,monocytes count,NEU%,INR,PT,NEU,AST,TBil,Cr,BUN,TG,PCT,and CRP than the non-ACLF group,and HCO₃^-,HDL-C and PTA were lower than those in the non-ACLF group.Multivariate logistic analysis showed that HE,hepatorenal syndrome and NLR were independent risk factors for 28-day prognosis in patients with SAH.Infection,hepatorenal syndrome,TBil,and INR are independent risk factors for the development of ACLF in SAH.The above differences were statistically significant（all P values<0.05）.ROC curve analysis showed that NLR could be used as an independent model to predict the prognosis of SAH patients for 28 days.Among the six scoring models,the score with the best predictive value at 28 days was CLIF-SOFA;The best predictive value score at 90 days was MELD;After combining the four models of GAHs,MDF,MELDand ABIC with NLR,the AUC of the above models increased compared with the previous one.Conclusion:Infection is an independent risk factor for the development of ACLF in patients with SAH,and the mortality rate increases significantly when SAH is co-infected.NLR is an independent risk factor affecting the 28-day prognosis of SAH patients,and can be used as an independent model to predict the prognosis of SAH patients at 28 days.Among the six scoring models,CLIF-SOFA scored the best predictive value for 28 days and MELD for the best predictive value at 90 days.