P- 40 PENTOXIFYLLINE USE IN PATIENTS WITH ALCOHOL-ASSOCIATED HEPATITIS ADMITTED WITH ACUTE KIDNEY INJURY COULD DECREASE SURVIVAL: A GLOBAL STUDY
Bibliographic record
Abstract
Alcohol-associated hepatitis (AH) is a severe entity with a mortality of up to 30–50% at 1 month. Pentoxifylline combined with steroids has not demonstrated benefits in severe AH. Some studies have suggested that pentoxifylline may be beneficial in the subgroup of patients with acute kidney injury (AKI) and AH. However, there is no solid evidence of its benefit in mortality in this setting. This study aimed to determine the benefit of the use of pentoxifylline in patients with severe AH and AKI. Global retrospective cohort study, including patients with severe AH and AKI at admission (2009–2019). We used competing-risk models with liver transplantation as a competing risk to assess the potential effect of pentoxifylline. We included 655 patients with severe AH and AKI (30 centers from 10 countries). Median age was 48±11.6 years, 26.2% were females, and 52.5% were Caucasian. Around 68.7% of the patients had a prior history of cirrhosis, and 6.6% underwent liver transplantation. The MELD score on admission was 34 [15–74]. 43.2% of the patients used corticosteroids, while only 6.9% used pentoxifylline during hospitalization. In the univariate analysis, the variables independently associated with mortality were the female sex (sHR 0.740; 95%IC:0.577–0.948; p=0.018), MELD (sHR 1.034; 95%IC: 1.020–1048; p<0.001), MELD 3.0 (sHR 1.034,95%IC:1.018–1.049, p<0.001), Maddrey's discriminant function (sHR 1.005, 95%IC:1.003–1.008, p<0.001), serum albumin at admission (sHR 0.756; 95%IC:0.642–0.890; p=0.001), bilirubin at admission (sHR 1.011; 95%IC:1.003–1.019, p=0.006), serum creatinine (sHR 1.083; 95%IC:1.028–1.140, p=0.002) and pentoxifylline use (sHR 1.531, 95%IC:1.107–2.119; p=0.010)(Table). In the multivariate-adjusted model, the use of pentoxifylline was associated with increased mortality (sHR 1.620, 95%IC:1.190–2.204; p=0.002). The use of pentoxifylline has no benefit in terms of mortality and could decrease survival in patients with AH and AKI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".