[Three prognostic utility scales to determine early mortality in patients with alcoholic hepatitis in the General Hospital of Mexico].
BACKGROUND
There are many models to predict survival in patients with alcoholic hepatitis (AH). The most commonly used are the modified Maddrey's index, the Glasgow scale and the Model for End stage Liver Disease (MELD).


OBJECTIVE
To evaluate three prognostic scales ability to predict early mortality (first 30 days) in patients with AH.


METHODS
We retrospectively reviewed the database of hospitalized patients with AH during a 3-years period. Seventy one patients were included. We calculated the modified Maddrey's index, the Glasgow scale and the MELD scores. We evaluated if the scales predicted early (30-day) mortality. For each scale we determined sensitivity, specificity, positive and negative values (PPV and NPV) and likelihood value of each scale.


RESULTS
For modified Maddrey's index, the values obtained were sensitivity 98.8%, specificity 11.7%, PPV 61.6%, NPV 87.5% and likelihood ratio 1.12. For Glasgow scale corresponding values were sensitivity 98.8%, specificity 61.7%, PPV 78.7%, NPV 97.4% and likelihood ratio 2.64. For the MELD scale sensitivity 98.8%, specificity 0.1%, PPV 59%, NPV 50% and likelihood ratio 1.


CONCLUSIONS
The three scales were very sensitive. Glasgow's scale was the most specific and, maybe, the most exact test.
Higuera-de la Tijera
M F
MF
Servicio de Gastroenterología Unidad 107, Hospital General de México O.D., México, D. F., Mexico. fatimahiguera@yahoo.com.mx
Pérez-Hernández
J L
JL
Serralde-Zúñiga
A E
AE
Servín-Caamaño
A I
AI
Cruz-Palacios
A
A
Bernal-Sahagún
F
F
Salas-Gordillo
F
F
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D058625:End Stage Liver Disease / Q000401:mortality; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D016013:Likelihood Functions; D008108:Liver Diseases, Alcoholic / Q000401:mortality*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult