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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2025; 31(43): 113141
Published online Nov 21, 2025. doi: 10.3748/wjg.v31.i43.113141
Published online Nov 21, 2025. doi: 10.3748/wjg.v31.i43.113141
From rescue to recovery: Reframing severe alcoholic hepatitis management through 90-day survival
Amira A A Othman, Department of Internal Medicine, Suez University, Suez 43511, Egypt
Author contributions: Othman AAA conceptualized the manuscript theme, reviewed the relevant literature, and wrote the manuscript.
Conflict-of-interest statement: The author declares no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amira A A Othman, MD, PhD, Chief Physician, Professor, Department of Internal Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt.
Received: August 18, 2025
Revised: September 30, 2025
Accepted: October 22, 2025
Published online: November 21, 2025
Processing time: 96 Days and 12.9 Hours
Revised: September 30, 2025
Accepted: October 22, 2025
Published online: November 21, 2025
Processing time: 96 Days and 12.9 Hours
Core Tip
Core Tip: Severe alcoholic hepatitis (SAH) is characterized by high short-term mortality, yet traditional 28-day endpoints overlook late complications that often determine recovery. This manuscript highlights a systematic review advocating 90-day survival as a more meaningful metric, capturing threats such as infections, renal decline, and relapse. Emerging therapies, fecal microbiota transplantation and granulocyte colony-stimulating factor, show potential in this extended window, particularly for corticosteroid non-responders. A proposed two-phase care model, early stabilization followed by recovery consolidation, may bridge the gap between initial rescue and sustained remission in SAH.