Ramírez-Mejía MM, Morales-Galicia AE, Méndez-Sánchez N. Prognostic challenges in alcoholic hepatitis: From scoring systems to clinical predictors. World J Hepatol 2025; 17(5): 105769 [DOI: 10.4254/wjh.v17.i5.105769]
Corresponding Author of This Article
Nahum Méndez-Sánchez, MD, PhD, Professor, Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City 14050, Mexico. nmendez@medicasur.org.mx
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. May 27, 2025; 17(5): 105769 Published online May 27, 2025. doi: 10.4254/wjh.v17.i5.105769
Prognostic challenges in alcoholic hepatitis: From scoring systems to clinical predictors
Mariana M Ramírez-Mejía, Arnulfo E Morales-Galicia, Nahum Méndez-Sánchez
Mariana M Ramírez-Mejía, Arnulfo E Morales-Galicia, Nahum Méndez-Sánchez, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04360, Mexico
Nahum Méndez-Sánchez, Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
Author contributions: Ramírez-Mejía MM, Morales-Galicia AE, and Méndez-Sánchez N contributed to the writing and editing of the manuscript, the illustrations, and the review of the literature; Ramírez-Mejía MM and Morales-Galicia AE contributed to the discussion and design of the manuscript; Méndez-Sánchez N designed the overall concept and outline of the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Nahum Méndez-Sánchez, MD, PhD, Professor, Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City 14050, Mexico. nmendez@medicasur.org.mx
Received: February 7, 2025 Revised: March 20, 2025 Accepted: March 20, 2025 Published online: May 27, 2025 Processing time: 110 Days and 5.9 Hours
Abstract
In this article, we discuss the recently published article by Yang et al. This retrospective analysis, which was conducted at a large urban tertiary care center, focused on comparing Lille model scores at days 3 and 7 with established scoring systems and identifying critical clinical predictors, such as renal dysfunction, nutritional status, and underlying cirrhosis. Alcoholic hepatitis (AH), a severe manifestation of alcohol-related liver disease, is associated with high morbidity and mortality, necessitating accurate prognostic tools and comprehensive clinical assessments. Prognostic tools are invaluable for early risk stratification, but they must be contextualized within the multifactorial nature of AH. Acute renal dysfunction and poor nutritional status, for example, are not just complications but pivotal markers of disease severity and systemic impact. Addressing these factors requires a holistic approach that extends beyond scoring systems to include targeted interventions and comprehensive patient care. This editorial emphasizes the need for a paradigm shift in AH management, where prognostic models are complemented by a deeper understanding of patient-specific factors. Such an approach can guide clinicians in tailoring therapies and improving outcomes for this high-risk population.
Core Tip: Prognostic scoring systems, particularly the Lille model, play a crucial role in the treatment of alcoholic hepatitis by facilitating the early identification of patients who do not respond to corticosteroid therapy. The study by Yang et al highlights the predictive value of Lille model 3-7 and underlines the importance of timely treatment adjustment to minimize complications. The study also highlights the impact of nutritional deficits and renal dysfunction on mortality, suggesting a multidisciplinary approach that integrates early nutritional interventions and nephroprotective strategies to improve patient outcomes.
