Hyperbilirubinemia may occur during severe alcoholic hepatitis. The response of the serum bilirubin concentration to corticosteroid therapy has prognostic significance.
Patient selection: severe alcoholic hepatitis with hyperbilirubinemia
Intervention: corticosteroid therapy
A 25% fall in the serum bilirubin concentration after 6 to 9 days of corticosteroid therapy indicates a therapeutic response and is associated with a more favorable outcome. Failure to show the fall is associated with a worse prognosis.
Performance:
• The area under the ROC curve for 30-day and 90-day mortality is 0.73.
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