Prothrombin Time Predicts Steroid Response in Severe Alcoholic Hepatitis.

Inclusion criteria

• clinical diagnosis of first episode of severe alcoholic hepatitis with Maddrey's function score of 32 or higher, and the absence of contraindication to CS therapy (non-controlled infections/sepsis, hepatic encephalopathy, recent acute gastrointestinal bleeding, severe kidney dysfunction). The diagnosis of AH was based on the criteria of the National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded Alcoholic Hepatitis Consortia (Crabb DW, 2016). In particular, were enrolled in the study patients with: heavy alcohol use for >6 months, with an average consumption of more than 3 drinks (∼40 g) per day for women and 4 drinks (∼50-60 g) per day for men and with <30 days of abstinence before the onset of jaundice; AST/ALT ratio > 1.5 with an AST level > 45 IU/L (1.5 times upper limit of normal) and < 400 IU/L; serum bilirubin >3 mg/dL.

Exclusion criteria

• acute or chronic viral hepatitis,
• nonalcoholic steatohepatitis,
• cocaine use,
• drug-induced liver injury,
• fulminant Wilsons disease,
• hepatocellular carcinoma,
• portal vein thrombosis,
• biliary obstruction,
• severe autoimmune liver disease,
• neoplasms,
• severe comorbidities.