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World J Gastroenterol. Aug 14, 2026; 32(30): 118301
Published online Aug 14, 2026. doi: 10.3748/wjg.118301
Published online Aug 14, 2026. doi: 10.3748/wjg.118301
Risk-stratified assessment of 180-day mortality in severe alcoholic hepatitis
Yi-Wen Xv, Jun Ling, Tian-Jiao Xu, Hua Tian, Sa Lv, Shao-Li You, Bing Zhu, Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Xiao-Gang Hao, Department of Inpatient and Medical Record Management, The Fifth Medical Centre of Chinese PLA General Hospital, Beijing 100039, China
Co-first authors: Yi-Wen Xv and Jun Ling.
Co-corresponding authors: Shao-Li You and Bing Zhu.
Author contributions: Xv YW Ling J contribute equally to this study as co-first authors; You SL and Zhu B contribute equally to this study as co-corresponding authors; Xv YW was responsible for writing-original draft, methodology, investigation, formal analysis, data curation, and conceptualization; Ling J was responsible for methodology and formal analysis; Hao XG was responsible for writing-review & editing, and data curation; Xv TJ and Tian H were responsible for data curation; Lv S was responsible for writing-review & editing; You SL was responsible for writing-review & editing, conceptualization, and supervision; Zhu B was responsible for writing-review & editing, funding acquisition, and supervision.
Supported by Capital’s Funds for Health Improvement and Research, China, No. 2024-1-2181; and National Science and Technology Major Projects of China, No. 2025ZD01906302.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the Fifth Medical Center of Chinese PLA General Hospital (No. KY-ZDZX-2025-11-212-1).
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available owing to patient confidentiality agreements but are available from the corresponding author on reasonable request.
Corresponding author: Bing Zhu, Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital, No. 100 West Fourth Ring Middle Road, Fengtai District, Beijing 100039, China. zhubing302@163.com
Received: January 6, 2026
Revised: February 12, 2026
Accepted: April 13, 2026
Published online: August 14, 2026
Processing time: 199 Days and 0.2 Hours
Revised: February 12, 2026
Accepted: April 13, 2026
Published online: August 14, 2026
Processing time: 199 Days and 0.2 Hours
Core Tip
Core Tip: This study identified distinct clinical phenotypes of severe alcoholic hepatitis (SAH) using interpretable machine learning, enhancing prognosis precision. By analyzing 1536 patients, we found that creatinine and total bilirubin levels are key predictors of 180-day mortality. A novel two-step risk stratification model revealed significant mortality variations, classifying patients into four tiers with survival rates ranging from 5% to over 50%. This tool facilitates rapid risk assessment and informed treatment decisions, marking a significant advancement in managing SAH.