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Utility of platelet indices in alcoholic hepatitis: a retrospective study.

ABSTRACT: Background:The commonly available platelet indices are platelet distribution width (PDW), plateletcrit (PCT), and mean platelet volume (MPV). They have been used in diagnosis and prognosis of various abdominal disorders. They have never been used to predict severity of alcoholic hepatitis. Methods:A retrospective analysis of chronic alcohol consumers presenting with jaundice and deranged liver function tests was performed. Maddrey discriminant function (MDF) and modified end-stage liver disease (MELD) scores were calculated and patients compared between severe and nonsevere alcoholic hepatitis (MDF ?32 vs MDF <32 and MELD >20 vs MELD ?20). Logistic regression analysis was performed to find significant predictors. Receiver operating characteristic was used to find the area under the curve. Spearman correlation was performed to discover association between platelet indices and severity scores. Results:There were 119 patients in the study. Coexisting illnesses included pancreatitis, cirrhosis, infections, and alcohol withdrawal syndrome. The mean age (years), duration of alcohol consumption (years), and ethanol (g/day) were 45.13?±?11.53, 18.84?±?11.40, and 65.61?±?45.42, respectively. The average MELD and Maddrey scores were 14.13?±?5.17 and 36.45?±?29.63, respectively. The mean platelet counts, PDW, MPV, and PCT were 194.01?±?178.82?×?109/L, 17.10?±?1.21, 5.99?±?0.96, and 0.14?±?0.04, respectively. PDW >18 and MPV had a significant positive correlation with MELD scores. Only bilirubin and prothrombin prolongation were significant predictors of severe alcoholic hepatitis. The area under the curve was highest for PCT at 0.622 (P?=?.07; confidence interval?=?0.500-0.743). Conclusions:Platelet indices appear to be significantly altered in alcoholic hepatitis, but they do not predict severe disease. Whether this inability to predict severe alcoholic hepatitis is due to coexisting illnesses such as pancreatitis, cirrhosis, and infection needs to be studied further.

SUBMITTER: Vijayakumar S

PROVIDER: S-EPMC7657577 | biostudies-literature | 2020 Sep-Oct

REPOSITORIES: biostudies-literature

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Utility of platelet indices in alcoholic hepatitis: a retrospective study.

Vijayakumar Saravanakumari S Viswanathan Stalin S Jain Dheeraj D

Porto biomedical journal 20200916 5

<h4>Background</h4>The commonly available platelet indices are platelet distribution width (PDW), plateletcrit (PCT), and mean platelet volume (MPV). They have been used in diagnosis and prognosis of various abdominal disorders. They have never been used to predict severity of alcoholic hepatitis.<h4>Methods</h4>A retrospective analysis of chronic alcohol consumers presenting with jaundice and deranged liver function tests was performed. Maddrey discriminant function (MDF) and modified end-stage ...[more]

PMID: 33195872

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Project description:AimTo verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis (SAH).MethodsWe performed a retrospective cohort study in consecutive patients diagnosed with SAH at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. The traditional Chinese medicine formula Gutuo Jiejiu decoction was employed as an exposure factor. Patients from the Teaching Hospital of Chengdu University of Traditional Chinese Medicine who had been treated with Gutuo Jiejiu decoction + prednisone were assigned to an observation group, and patients from Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who had been treated with prednisone alone were selected as a control group. A retrospective analysis was performed by comparing age, alcohol intake, and clinical parameters of liver injury before and after treatment. Additionally, the 3- and 12-mo survival rates and the occurrence of complications were analyzed.ResultsOne hundred and twenty-eight eligible patients were selected from 175 cases with SAH, of which 68 were assigned to the observation group and the other 60 to the control group. No significant difference was found in the patients' baseline characteristics (P > 0.05). However, significant improvements of 90-d survival rate [56/68 (82.4%) vs 27/60 (45.0%), P = 0.0000] and 365-d survival rate [48/68 (70.6%) vs 13/60 (21.7%), P = 00000] were observed in the observation group after treatment. After the first 3 mo of treatment, more improvements in the clinical parameters and scoring systems related to liver injury occurred in the observation group than in the control group (P < 0.05). After treatment for 12 mo, the differences in the clinical parameters and scoring systems related to liver injury between the two groups were more significant (P < 0.05). No significant differences in complications and adverse effects were found between the two groups.ConclusionGutuo Jiejiu decoction could improve the survival rates and clinical parameters of liver injury in patients with SAH, and may represent a new option for treating SAH.

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Utility of platelet indices in alcoholic hepatitis: a retrospective study.

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Utility of platelet indices in alcoholic hepatitis: a retrospective study.

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