Beyond the ICU: A 90-Day Roadmap for Severe Alcoholic Hepatitis

Severe alcoholic hepatitis causes rapid decline and high early death. Shifting the goal to 90-day survival reframes care from short-term rescue to longer recovery. Teams should combine medical therapy, infection control, nutrition, addiction support, and timely transplant evaluation to improve outcomes.

Severe alcoholic hepatitis often strikes suddenly. Patients can get much worse in days. Early death rates are high, and urgent care teams face hard choices.

Thinking beyond the first days changes how doctors plan treatment. A 90-day survival goal means moving from quick fixes to a plan for the coming months. That plan mixes medicines, close infection checks, and careful nutrition.

Steroids and other liver-directed treatments may help some patients at first. But lasting gains need attention to infections and organ support. Small steps in care can matter a lot over weeks.

For some people, a liver transplant is the best chance to survive. Earlier evaluation and fair patient selection can speed lifesaving care. Transplant programs must also work with addiction teams to support long-term success.

Addiction treatment is essential. Without help to stop drinking, recovery is fragile. Counseling, medicines for alcohol use disorder, and family support should start in the hospital and continue after discharge.

Nutrition and social care are often overlooked but are vital for healing. Good calories, vitamins, and help with housing or money improve recovery odds. Teams should include dietitians and social workers.

Researchers need trials that use 90-day survival as a main measure. That will show which approaches truly change outcomes. Consistent research methods will help hospitals learn what works.

The shift to 90-day thinking asks hospitals to act together. Medical teams, addiction specialists, transplant programs, and social services must coordinate. That teamwork gives patients the best shot at recovery.