Characterization of gastrointestinal hemorrhage and prediction of mortality in Asian patients with alcoholic hepatitis

Su Hwan Kim, Byeong Gwan Kim, Won Kim, Sohee Oh, Hwi Young Kim, Yong Jin Jung, Ji Bong Jeong, Ji Won Kim, Kook Lae Lee

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background and Aim:: Gastrointestinal bleeding (GIB) often accompanies alcoholic hepatitis (AH). The study aimed to investigate clinical characteristics of GIB in AH patients and to identify risk factors for mortality in AH patients with GIB. Methods:: Data from 329 patients hospitalized with AH in a single center during 1999-2014 were retrospectively analyzed. Patients with AH were dichotomized into GIB and non-GIB groups. The GIB group was further divided into portal hypertensive bleeding (PHB) and non-PHB groups. Clinical characteristics and survival outcomes were compared between the groups. Risk factors for mortality were analyzed using Cox regression. Results:: Among the 329 AH patients, 132 experienced GIB at admission or during hospitalization. The most common cause of GIB was an esophageal varix. The GIB group had worse survival outcomes than the non-GIB group (log-rank test, P=0.034). The PHB group had worse survival outcomes than the non-PHB group (log-rank test, P=0.001). On multivariate analysis, alcohol consumption, ascites, encephalopathy, infection, Maddrey's discriminant function, and the model for end-stage liver disease (MELD) score independently predicted mortality in the entire AH cohort. The MELD score (hazard ratio, 1.085; 95% confidence interval, 1.052-1.120; P<0.001) and PHB (hazard ratio, 2.162; 95% confidence interval, 1.021-4.577; P=0.044) were significant prognosticators for patients with AH and GIB. Conclusions:: The presence of PHB and a higher MELD score adversely affected survival in AH patients with GIB. Accordingly, prompt endoscopic examination for exploring the etiologies of GIB may alert physicians to predict the risk of death in AH patients with GIB.

Original languageEnglish
Pages (from-to)814-821
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number4
StatePublished - 1 Apr 2016

Bibliographical note

Publisher Copyright:
© 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.


  • Gastrointestinal hemorrhage
  • Maddrey's discriminant function
  • Model for end-stage liver disease
  • Mortality
  • Portal hypertension


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