[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].
OBJECTIVE
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.
Jeong
Jae Yoon
JY
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sohn
Joo Hyun
JH
Son
Byoung Kwan
BK
Paik
Chang Hee
CH
Kim
Seok Hwan
SH
Han
Dong Soo
DS
Jeon
Yong Chul
YC
Lee
Min Ho
MH
Lee
Dong Hoo
DH
Kee
Choon Suk
CS
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006519:Hepatitis, Alcoholic / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D007723:Korea; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors