{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:00:54Z","timestamp":1754398854443,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,27]],"date-time":"2024-10-27T00:00:00Z","timestamp":1729987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Severity scores, including the model for end\u2010stage liver disease (MELD) and discriminant function score, guide the treatment of patients with severe alcohol\u2010associated hepatitis (AH). We aimed to investigate the impact of functional status on outcomes of patients with AH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medically managed patients (<jats:italic>n<\/jats:italic> =\u2009133) with AH from 1 January 2019 to 31 December 2022 were included in this prospective study. The objectives were to compare the long\u2010term survival, recompensation rates, corticosteroid response, incidence of infections, hepatic encephalopathy (HE) and acute kidney injury (AKI) among propensity score\u2010matched patients with good Karnofsky performance status (KPS) (score \u226550) and poor KPS (score &lt;50) using Kaplan\u2013Meier analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five patients with good KPS were matched with 25 patients with poor KPS and followed up for a median duration of 10 (0.5\u201333) months. Survival was 76% (19\/25; 95% confidence interval (CI), 54.9\u201390.6) in patients with good KPS compared to 42.3% (11\/25; 95% CI, 23.4\u201363.1) patients with poor KPS (<jats:italic>P<\/jats:italic> =\u20090.001) at 10 months. The recompensation rate was higher in the good KPS group than in the poor KPS group (68% vs 44%; <jats:italic>P<\/jats:italic> =\u20090.04). A higher proportion of patients in the good KPS group (78.9%) than in the poor KPS group (42.8%; <jats:italic>P<\/jats:italic> =\u20090.03) responded to corticosteroids. Survival was lower among non\u2010responders in the poor KPS group (0% vs 75%; <jats:italic>P<\/jats:italic> =\u20090.01). The proportion of patients who developed infection (36% vs 28%; <jats:italic>P<\/jats:italic> =\u20090.051), HE (36% vs 12%; <jats:italic>P<\/jats:italic> =\u20090.01) and AKI (60% vs 16%; <jats:italic>P<\/jats:italic> &lt;\u20090.001) was higher in patients with poor KPS than in good KPS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>KPS is an important determinant of outcomes in patients with AH, including survival, recompensation, response to corticosteroids and complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16562","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T05:35:37Z","timestamp":1730093737000},"page":"109-116","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of <scp>Karnofsky<\/scp> performance status on outcomes of patients with severe alcohol\u2010associated hepatitis: a propensity\u2010matched analysis"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-1675","authenticated-orcid":false,"given":"Anand V.","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shantan","family":"Venishetty","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Hepatology Mahatma Gandhi Medical College  Jaipur India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitish","family":"Gurav","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somaya","family":"Albhaisi","sequence":"additional","affiliation":[{"name":"Department of Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prateek","family":"Chhabbra","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Shaik","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manasa","family":"Alla","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sowmya","family":"Iyengar","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mithun","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Padaki N.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan P.","family":"Arab","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Schulich School of Medicine, Western University &amp; London Health Sciences Centre  London Ontario Canada"},{"name":"Department of Epidemiology and Biostatistics Schulich School of Medicine, Western University  London Ontario Canada"},{"name":"Departamento de Gastroenterologia, Escuela de Medicina Pontificia Universidad Catolica de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duvvur N.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Hepatology AIG Hospitals  Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.7683"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30866"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.06.019"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2023.100727"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.03.036"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.04.024"},{"key":"e_1_2_6_8_1","first-page":"301","article-title":"The use of Karnofsky performance status (KPS) as a predictor of 3 month post discharge mortality in cirrhotic patients","volume":"11","author":"Khalid MA","year":"2018","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2019.06.006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.05.025"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05891-1"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2207599"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/LVT.0000000000000448"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21607"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.022"},{"key":"e_1_2_6_16_1","article-title":"Predictors and outcomes of infections in ICU patients with cirrhosis: a single\u2010center observational study","volume":"15","author":"Kulkarni A","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-013-0362-0"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308874"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-021-00527-0"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0192393"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412278"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.02.033"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28900"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.469"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gox042"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15400"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00430-1"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2023.101098"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12695"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.06.007"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/poh2.18"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.16562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T04:55:38Z","timestamp":1739940938000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.16562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,27]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/imj.16562"],"URL":"https:\/\/doi.org\/10.1111\/imj.16562","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2024,10,27]]},"assertion":[{"value":"2024-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}