{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:58:44Z","timestamp":1792036724086,"version":"4.4.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T00:00:00Z","timestamp":1506384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T00:00:00Z","timestamp":1506384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:p>\n                    Understanding the mechanisms of outcome according to the time frame can help optimize the therapeutic development in severe alcoholic hepatitis. We assessed short\u2010term and long\u2010term survival in severe alcoholic hepatitis based on baseline disease severity, extent of therapeutic improvement, long\u2010term influence of alcohol relapse, and their interaction. Data and alcohol consumption were prospectively recorded in 398 patients treated with corticosteroids in the short term (from corticosteroid initiation to 6 months) and long term (from 6 months to maximum follow\u2010up time). Cumulative incidence rate of first alcohol relapse was 25.2%, 33.7%, and 35.2% at 1, 3, and 5 years, respectively. Alcohol relapse (\u226530\u2009g\/day) was not associated with mortality (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.24) during the short\u2010term period (1,606 patient\u2010months at risk), but the Lille (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001) and Model for End\u2010Stage Liver Disease (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001) scores were independent prognostic factors. In patients who were alive at 6 months (median follow\u2010up, 42 months; interquartile range 11\u201088), corresponding to 10,413 patient\u2010months at risk, alcohol consumption (\u226530\u2009g\/day) was associated with mortality (hazard ratio, 3.9;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Additional analysis with abstinent patients as a reference showed a dose effect of alcohol on the hazard ratio of death: 2.36 (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.052) for 1\u201029\u2009g\/day, 3.2 (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.003) for 30\u201049\u2009g\/day, 3.51 (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001) for 50\u201099\u2009g\/day, and 5.61 (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001) for\u2009\u2265\u2009100\u2009g\/day. The baseline Model for End\u2010Stage Liver Disease score was not predictive of long\u2010term outcome, while Lille score (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.02) and alcohol relapse (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001) were independent prognostic factors.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>\n                    : This study shows that new therapeutic development for severe alcoholic hepatitis must target liver injury in the short term and alcohol consumption in the long term; thus, health agencies can endorse future study designs adapted to the time frame of factors influencing mortality; with this in mind, drug\u2010targeting mechanisms involved in liver injury should only be tested for the short\u2010term period. (H\n                    <jats:sc>epatology<\/jats:sc>\n                    2017;66:1464\u20131473)\n                  <\/jats:p>","DOI":"10.1002\/hep.29240","type":"journal-article","created":{"date-parts":[[2017,4,30]],"date-time":"2017-04-30T20:27:14Z","timestamp":1493584034000},"page":"1464-1473","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":207,"title":["Main drivers of outcome differ between short term and long term in severe alcoholic hepatitis: A prospective study"],"prefix":"10.1097","volume":"66","author":[{"given":"Alexandre","family":"Louvet","sequence":"first","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"},{"name":"Unit\u00e9 INSERM 995, Facult\u00e9 de m\u00e9decine,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Labreuche","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biostatistiques, CHRU de Lille,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florent","family":"Artru","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"},{"name":"Unit\u00e9 INSERM 995, Facult\u00e9 de m\u00e9decine,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Bouthors","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Rolland","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Saffers","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Lollivier","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Lema\u00eetre","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Dharancy","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"},{"name":"Unit\u00e9 INSERM 995, Facult\u00e9 de m\u00e9decine,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Lassailly","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"},{"name":"Unit\u00e9 INSERM 995, Facult\u00e9 de m\u00e9decine,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Canva\u2010Delcambre","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Duhamel","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biostatistiques, CHRU de Lille,Lille,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Mathurin","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'appareil digestif, H\u00f4pital Huriez,Lille,France"},{"name":"Unit\u00e9 INSERM 995, Facult\u00e9 de 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