MORTALITY TRENDS AND RISK FACTORS IN ALCOHOL-ASSOCIATED HEPATITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Bibliographic record
Abstract
Severe alcohol-associated hepatitis (sAH) is a life-threatening condition with high short-term mortality. Despite therapeutic advances, long-term effectiveness remains limited. We conducted a systematic review and meta-analysis to evaluate mortality trends in sAH over the past five decades. We searched PubMed, EMBASE, and Scopus through February 2024 for studies reporting 28-, 60-, and 90-day mortality in sAH. Pooled mortality estimates were calculated using mixed-effects models. Heterogeneity was assessed using the I 2 statistic, with subgroup and meta-regression analyses exploring potential modifiers. Bayesian models estimated the posterior probability distribution of mortality. Forty-five studies comprising 5,632 patients were included. Pooled mortality was 28.3% (95% CI: 22.5–34.8%) at 28 days, 38.3% (95% CI: 31.5–45.5%) at 60 days, and 48.7% (95% CI: 39.2–58.3%) at 90 days. Heterogeneity across studies was high (I 2 > 80%). Bayesian models suggested a decline in 28-day mortality from over 50% in the 1970s to approximately 25% after 2000; however, no consistent reduction in overall mortality was observed. Meta-regression showed no significant association with sex, age, mDF, or publication year, but higher MELD scores were linked to increased mortality (β = +0.20 per point; 95% CI: +0.01 to +0.39; p = 0.037). The use of corticosteroids, NAC, or G-CSF did not significantly affect mortality. Despite improved supportive care, short-term mortality in sAH remains high and unchanged over recent decades. These findings underscore the urgent need for effective treatments and support early liver transplant consideration in selected patients.
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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) | 0.003 | 0.001 |
| 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".