Risk-stratified assessment of 180-day mortality in severe alcoholic hepatitis

doi:10.3748/wjg.118301

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Aug 14, 2026; 32(30): 118301
Published online Aug 14, 2026. doi: 10.3748/wjg.118301

Table 1 Baseline characteristics of the study population

Variable	Overall (n = 1536)	Survived (n = 962)	Died (n = 574)	P value
MDF	51.00 (40.00-68.00)	45.50 (37.00-57.00)	64.00 (51.00-82.75)	< 0.001
MELD	16.00 (13.00-20.00)	14.00 (12.00-17.00)	19.00 (16.00-24.00)	< 0.001
Gender (male)	1495 (97.3)	934 (97.1)	561 (97.7)	0.515
Age (year)	48.00 (42.00-54.00)	48.00 (41.00-54.00)	48.00 (43.00-55.00)	0.086
ALB (g/L)	26.00 (22.00-29.00)	27.00 (23.00-30.00)	24.00 (20.00-28.00)	< 0.001
GLO (g/L)	29.00 (23.00-35.00)	30.00 (24.00-36.00)	27.00 (21.00-33.00)	< 0.001
ALT (U/L)	31.00 (21.00-47.00)	29.00 (20.00-42.00)	35.00 (23.00-54.00)	< 0.001
AST (U/L)	69.00 (46.00-111.00)	64.00 (44.00-102.75)	81.00 (52.00-124.00)	< 0.001
ALP (U/L)	136.00 (103.00-182.00)	139.00 (106.00-186.00)	130.00 (95.00-177.00)	0.008
GGT (U/L)	70.00 (32.00-166.00)	73.00 (33.00-165.00)	66.50 (30.00-167.50)	0.371
TBA (μmol/L)	131.00 (70.83-198.25)	127.75 (72.00-199.75)	136.00 (65.25-197.00)	0.952
PTS (second)	20.00 (18.00-23.00)	19.00 (18.00-21.75)	22.00 (20.00-26.00)	< 0.001
PTA (%)	37.00 (31.10-42.10)	38.90 (34.00-42.80)	33.50 (27.02-39.80)	< 0.001
TBIL (μmol/L)	165.40 (97.10-302.15)	129.05 (80.53-235.73)	241.35 (149.90-372.05)	< 0.001
INR	1.74 (1.60-1.99)	1.68 (1.58-1.88)	1.90 (1.68-2.23)	< 0.001
CRE (μmol/L)	83.00 (68.00-112.25)	76.00 (64.00-95.00)	107.00 (79.25-164.75)	< 0.001
TG (mmol/L)	0.90 (0.60-1.37)	0.95 (0.64-1.37)	0.82 (0.55-1.39)	0.001
CHE (U/L)	2067.00 (1504.75-2707.25)	2236.00 (1672.25-2842.75)	1762.00 (1312.00-2469.50)	< 0.001
CK (U/L)	67.00 (39.00-118.00)	69.00 (40.00-118.00)	65.00 (39.00-119.00)	0.979
FE (μmol/L)	19.80 (13.50-26.10)	20.00 (13.12-27.00)	19.50 (14.10-24.78)	0.388
AFP (ng/mL)	4.54 (2.77-8.00)	4.40 (2.81-7.84)	4.80 (2.73-8.88)	0.305
HGB (g/L)	97.00 (79.00-113.00)	99.00 (83.00-115.00)	92.70 (74.00-108.00)	< 0.001
PLT (× 10⁹/L)	71.00 (46.00-113.00)	72.50 (48.00-117.75)	68.20 (43.20-106.00)	0.017
SBP (yes)	473 (30.8)	238 (24.7)	235 (40.9)	< 0.001
Pulmonary infection (yes)	261 (17.0)	107 (11.1)	154 (26.8)	< 0.001
HRS (yes)	108 (7.0)	31 (3.2)	77 (13.4)	< 0.001
HE (yes)	373 (24.3)	139 (14.4)	234 (40.8)	< 0.001
Gastrointestinal bleeding (yes)	174 (11.3)	76 (7.9)	98 (17.1)	< 0.001
Glucocorticoid (yes)	96 (6.2)	41 (4.2)	55 (9.6)	< 0.001

Continuous variables are expressed as median (interquartile range) and categorical variables as n (%). MDF: Maddrey discriminant function; MELD: Model for end-stage liver disease; ALB: Albumin; GLO: Globulin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase; TBA: Total bile acid; PTS: Prothrombin time seconds; PTA: Prothrombin activity; TBIL: Total bilirubin; INR: International normalized ratio; CRE: Creatinine; TG: Triglyceride; CHE: Cholinesterase; CK: Creatine kinase; FE: Iron; AFP: Alpha-fetoprotein; HGB: Hemoglobin; PLT: Platelet Count; SBP: Spontaneous bacterial peritonitis; HRS: Hepatorenal syndrome; HE: Hepatic encephalopathy.

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Table 2 Comparison of baseline characteristics between the training and test sets

Variable	Training set (n = 1076)	Test set (n = 460)	P value
MDF	51.00 (40.00-67.25)	51.00 (40.00-69.00)	0.736
MELD	16.00 (13.00-20.00)	15.00 (13.00-19.00)	0.357
Gender (male)	1048 (97.4)	447 (97.2)	0.863
Age (years)	48.00 (42.00-54.00)	49.00 (43.00-55.00)	0.093
ALB (g/L)	26.00 (22.00-29.00)	26.00 (22.00-29.00)	0.313
GLO (g/L)	29.00 (23.00-35.00)	29.00 (23.00-36.00)	0.464
ALT (U/L)	30.00 (21.00-45.25)	31.00 (21.00-49.00)	0.288
AST (U/L)	69.00 (46.00-110.00)	69.00 (47.00-113.25)	0.664
ALP (U/L)	137.00 (103.00-185.00)	135.00 (104.00-176.25)	0.726
GGT (U/L)	69.00 (31.00-168.00)	74.50 (35.00-159.50)	0.254
TBA (μmol/L)	131.00 (69.00-197.00)	130.50 (74.07-201.75)	0.417
PTS (second)	20.00 (18.00-23.00)	20.00 (18.00-23.00)	0.484
PTA (%)	36.95 (31.08-42.30)	37.10 (31.27-42.00)	0.631
TBIL (μmol/L)	165.05 (97.10-305.95)	166.10 (97.08-293.00)	0.863
INR	1.73 (1.60-1.99)	1.76 (1.60-2.00)	0.404
CRE (μmol/L)	83.00 (67.00-116.00)	83.00 (68.00-107.00)	0.434
TG (mmol/L)	0.88 (0.60-1.37)	0.94 (0.63-1.37)	0.349
CHE (U/L)	2054.00 (1492.75-2703.00)	2080.50 (1524.50-2734.25)	0.343
CK (U/L)	69.00 (40.00-119.00)	65.00 (38.00-115.25)	0.298
FE (μmol/L)	19.55 (13.20-26.00)	20.25 (14.57-26.70)	0.133
AFP (ng/mL)	4.54 (2.75-8.02)	4.53 (2.81-8.00)	0.871
HGB (g/L)	96.00 (79.00-113.00)	99.00 (80.00-113.00)	0.503
PLT (× 10⁹/L)	71.20 (46.00-113.00)	71.00 (47.00-112.25)	0.875
SBP (yes)	323 (30.0)	150 (32.6)	0.334
Pulmonary infection (yes)	195 (18.1)	66 (14.3)	0.075
HRS (yes)	82 (7.6)	26 (5.7)	0.191
HE (yes)	263 (24.4)	110 (23.9)	0.846
Gastrointestinal bleeding (yes)	126 (11.7)	48 (10.4)	0.538
Glucocorticoid (yes)	73 (6.7)	24 (5.0)	0.247

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Table 3 Performance of the best-machine learning model and traditional scores in the training and test sets

Dataset	Model	AUC	Accuracy	Sensitivity	Specificity	Kappa
Test set	Best-ML (XGBoost)	0.848 (0.813-0.883)	0.785	0.719	0.824	0.541
Training set	Best-ML (XGBoost)	0.837 (0.795-0.880)	0.752	0.733	0.764	0.491
Test set	MELD	0.821 (0.784-0.859)	0.715	0.374	0.917	0.323
Training set	MELD	0.804 (0.757-0.851)	0.693	0.397	0.895	0.314
Test set	MDF	0.787 (0.745-0.829)	0.709	0.380	0.903	0.312
Training set	MDF	0.713 (0.658-0.769)	0.643	0.305	0.874	0.195

AUC: Area under the curve; ML: Machine learning; MDF: Maddrey discriminant function; MELD: Model for end-stage liver disease.

Full Size Table

Citation: Xv YW, Ling J, Hao XG, Xu TJ, Tian H, Lv S, You SL, Zhu B. Risk-stratified assessment of 180-day mortality in severe alcoholic hepatitis. World J Gastroenterol 2026; 32(30): 118301
URL: https://www.wjgnet.com/1007-9327/full/v32/i30/118301.htm
DOI: https://dx.doi.org/10.3748/wjg.118301

Xv YW, Ling J, Hao XG, Xu TJ, Tian H, Lv S, You SL, Zhu B. Risk-stratified assessment of 180-day mortality in severe alcoholic hepatitis. World J Gastroenterol 2026; 32(30): 118301 [DOI: 10.3748/wjg.118301]

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