Comparison of Model for End-stage Liver Disease Score with Discriminant Function and Child-Turcotte-Pugh Scores for Predicting Short-term Mortality in Korean Patients with Alcoholic Hepatitis.
- Author:
Jae Yoon JEONG
1
;
Joo Hyun SOHN
;
Byoung Kwan SON
;
Chang Hee PAIK
;
Seok Hwan KIM
;
Dong Soo HAN
;
Yong Chul JEON
;
Min Ho LEE
;
Dong Hoo LEE
;
Choon Suk KEE
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. sonjh@hanyang.ac.kr
- Publication Type:Comparative Study ; English Abstract
- Keywords:
Alcoholic hepatitis;
Mortality;
Prognosis
- MeSH:
Adult;
Female;
Follow-Up Studies;
Hepatitis, Alcoholic/diagnosis/*mortality;
Humans;
Korea;
Liver Diseases/diagnosis/mortality;
Male;
Middle Aged;
Predictive Value of Tests;
Prognosis;
ROC Curve;
*Severity of Illness Index;
Survival Analysis;
Time Factors
- From:The Korean Journal of Gastroenterology
2007;49(2):93-99
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Alcoholic hepatitis is an acute or acute-on-chronic inflammatory syndrome associated with significant morbidity and mortality. Traditionally, Maddrey discriminant function (DF) score and Child-Turcott- Pugh (CTP) score have been used for stratifying the prognosis of alcoholic hepatitis. Recently, the model for end-stage liver disease (MELD) score has been applied to alcoholic hepatitis and some investigators consider MELD score as a better prognostic indicator for severe alcoholic hepatitis. Therefore, this analysis was aimed to compare MELD score with DF and CTP scores for predicting the short-term mortality in Korean patients with alcoholic hepatitis. METHODS: The medical records of patients hospitalized with alcoholic hepatitis between January 1, 1999 and December 31, 2004 at Hanyang University Guri-Hospital were analyzed retrospectively. RESULTS: Of the 138 medical records reviewed, 74 cases fulfilled the inclusion criteria (61 males and 13 females; mean age 47.1 years). Twelve patients (16.2%) died within 90 days after admission. Univariate analysis demonstrated that variables such as ascites, hepatic encephalopathy, splenomegaly, international normalized ratio, CTP, and DF scores were significantly correlated with increased 90-day mortality while MELD score was not. According to the multivariate analysis, only CTP score was statistically significant (p=0.012) while DF and MELD scores were not significant for predicting 90-day mortality. The survival analysis with Cox regression test showed higher DF and CTP scores, but not MELD score, significantly increased the risk of in-hospital mortality. CONCLUSIONS: This study demonstrates that DF and CTP scores are independent predictors of short-term mortality in patients with alcoholic hepatitis.
