Model for end-stage liver disease score versus Maddrey discriminant function score in assessing short-term outcome in alcoholic hepatitis.

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  • Author(s): Kadian M;Kadian M;Kadian M; Kakkar R; Dhar M; Kaushik RM
  • Source:
    Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2014 Mar; Vol. 29 (3), pp. 581-8.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Blackwell Scientific Publications Country of Publication: Australia NLM ID: 8607909 Publication Model: Print Cited Medium: Internet ISSN: 1440-1746 (Electronic) Linking ISSN: 08159319 NLM ISO Abbreviation: J Gastroenterol Hepatol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Melbourne ; Boston : Blackwell Scientific Publications, c1986-
    • Subject Terms:
      Hepatitis, Alcoholic/*diagnosis ; Liver Function Tests/*methods ; Outcome Assessment, Health Care/*methods; Adult ; Confidence Intervals ; Discriminant Analysis ; End Stage Liver Disease ; Female ; Forecasting ; Hepatitis, Alcoholic/mortality ; Humans ; Male ; Middle Aged ; Prospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Time Factors
    • Abstract:
      Background and Aims: The Maddrey Discriminant Function (mDF) score and the Model for End-Stage Liver Disease (MELD) score are standard prognostic scores for predicting disease severity and mortality in alcoholic hepatitis (AH).This prospective study compared the MELD score and the mDF score as predictors of short-term outcome in AH.
      Methods: The admission MELD score and the mDF score were assessed in 47 patients with a diagnosis of AH in the Himalayan Institute Hospital, Dehradun, India and the concordance (C) statistics of the two scores for 28-day mortality were determined and compared.
      Results: Both the MELD score and the mDF score on day 1 were significantly higher in non-survivors than in survivors (P = 0.0001 each). The C-statistic for 28-day mortality for the MELD score was 0.91 (P < 0.0001, 95% confidence interval [CI] 0.79-0.97) and for the mDF score 0.90 (P < 0.0001, 95% CI 0.78-0.97). There was no significant difference between the C-statistics of the two scores (P = 0.83, 95% CI -0.07 to 0.09). For predicting 28-day mortality, the optimal MELD score of > 19 (sensitivity 91.6% and specificity 85.7%) corresponded to the mDF score of > 52.8 (sensitivity 91.6% and specificity 82.8%).
      Conclusions: Both the MELD score and the mDF score at admission were strong and equally good predictors of 28-day mortality in patients with AH, but the optimal mDF score corresponding to optimal MELD score was higher than the conventional one. Thus, MELD score may be used as an alternative to mDF score for predicting short-term mortality in AH with an advantage.
      (© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
    • Contributed Indexing:
      Keywords: India; MELD score; Maddrey Differential Function; alcoholic hepatitis; short-term outcome
    • Publication Date:
      Date Created: 20131015 Date Completed: 20141031 Latest Revision: 20191210
    • Publication Date:
      20250114
    • Accession Number:
      10.1111/jgh.12400
    • Accession Number:
      24117536