{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:50:15Z","timestamp":1791413415405,"version":"4.3.3"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":4292,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,12]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Early identification of patients with severe (discriminant function \u226532) biopsy\u2013proven alcoholic hepatitis (AH) who are not responding to corticosteroids would be clinically relevant. Our goal was to develop simple criteria that will help physicians to promptly identify nonresponders to corticosteroids. A total of 238 patients were included. We used 6 months survival as an end point because of the rule requiring 6 months for listing alcoholic patients for transplantation. Overall survival at 1 and 6 months was 85% \u00b1 2.3% and 64.3% \u00b1 3.3%, respectively. An early change in bilirubin levels (ECBL) at 7 days (defined as bilirubin level at 7 days lower than bilirubin level on the first day of treatment) was observed in 73% of patients. At 7 days, in patients with ECBL, bilirubin decreased (84 \u00b1 75 \u03bcmol\/L [4.94 \u00b1 4.40 mg\/dL]), whereas it increased in patients without ECBL (76.5 \u00b1 77 \u03bcmol\/L [4.50 \u00b1 4.54 mg\/dL], <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .0001). Ninety\u2013five percent of patients with ECBL continued to have improved liver function during treatment. At 6 months, survival of patients with ECBL was significantly higher than that of patients without ECBL, 82.8% \u00b1 3.3% versus 23% \u00b1 5.8%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .0001. On multivariate analysis, ECBL, discriminant function and creatinine were independent prognostic variables, and ECBL had the most important prognostic value. In conclusion, ECBL is a very simple predictive factor for identifying nonresponders. A recommendation to discontinue corticosteroids after 7 days in patients without ECBL, suggested by our results, awaits additional confirmation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1016\/j.hep.2003.09.038","type":"journal-article","created":{"date-parts":[[2003,11,25]],"date-time":"2003-11-25T20:29:01Z","timestamp":1069792141000},"page":"1363-1369","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":101,"title":["Early Change in Bilirubin Levels Is An Important Prognostic Factor in Severe Alcoholic Hepatitis Treated With Prednisolone"],"prefix":"10.1097","volume":"38","author":[{"given":"Philippe","family":"Mathurin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelle","family":"Abdelnour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9","family":"Ramond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Carbonell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Fartoux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Serfaty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Valla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raoul","family":"Poupon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Chaput","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Naveau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1016\/j.hep.2003.09.038-BIB1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.7326\/0003-4819-110-9-685","volume":"110","author":"Carithers","year":"1989","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.hep.2003.09.038-BIB2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0016-5085(78)90401-8","volume":"75","author":"Maddrey","year":"1978","journal-title":"Gastroenterology"},{"key":"10.1016\/j.hep.2003.09.038-BIB3","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/S0168-8278(01)00289-6","volume":"36","author":"Mathurin","year":"2002","journal-title":"J Hepatol"},{"key":"10.1016\/j.hep.2003.09.038-BIB4","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1056\/NEJM199202203260802","volume":"326","author":"Ramond","year":"1992","journal-title":"N Engl J Med"},{"key":"10.1016\/j.hep.2003.09.038-BIB5","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1111\/j.1572-0241.1998.00587.x","volume":"93","author":"Mc Cullough","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.hep.2003.09.038-BIB6","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0168-8278(02)00086-7","volume":"36","author":"Lucey","year":"2002","journal-title":"J Hepatol"},{"key":"10.1016\/j.hep.2003.09.038-BIB7","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/jhep.2001.22172","volume":"33","author":"Kamath","year":"2001","journal-title":"Hepatology"},{"key":"10.1016\/j.hep.2003.09.038-BIB8","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/S0140-6736(94)91897-X","volume":"344","author":"Poynard","year":"1994","journal-title":"Lancet"},{"key":"10.1016\/j.hep.2003.09.038-BIB9","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/S0168-8278(99)80269-4","volume":"30","author":"Poynard","year":"1999","journal-title":"J Hepatol"},{"key":"10.1016\/j.hep.2003.09.038-BIB10","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1080\/03610928208828251","volume":"11","author":"Kleinbaum","year":"1982","journal-title":"Theor Meth"},{"key":"10.1016\/j.hep.2003.09.038-BIB11","doi-asserted-by":"crossref","first-page":"s51","DOI":"10.1002\/lt.500040107","volume":"4","author":"Neuberger","year":"1998","journal-title":"Liver Transplant Surg"},{"key":"10.1016\/j.hep.2003.09.038-BIB12","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1002\/lt.500030305","volume":"3","author":"Everhart","year":"1998","journal-title":"Liver Transpl Surg"},{"key":"10.1016\/j.hep.2003.09.038-BIB13","first-page":"64","volume-title":"Statistic With Confidence","author":"Machin","year":"1989","unstructured":". 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