Utility of the Mayo End-Stage Liver Disease (MELD) score in assessing prognosis of patients with alcoholic hepatitis

被引：115

作者：

Sheth M. ^{[1
]}

Riggs M. ^{[2
]}

Patel T. ^{[1
]}

机构：

[1] Division of Gastroenterology, Scott and White Clinic, Texas A/M Univ. Health Science Ctr., Temple, TX

[2] Division of Biostatistics, Scott and White Clinic, Texas A/M Univ. Health Science Ctr., Temple, TX

来源：

BMC Gastroenterology | / 2卷 / 1期

关键词：

International Normalize Ratio; Discriminant Function; Alcoholic Hepatitis; Alcoholic Liver Injury; Severe Alcoholic Hepatitis;

D O I：

10.1186/1471-230X-2-2

中图分类号：

学科分类号：

摘要：

Background: Alcoholic hepatitis is characterized by acute, or acute-on-chronic hepatic failure and associated with a high mortality. Specific therapies should be considered for those at high risk of mortality. The Mayo End-Stage Liver Disease (MELD) score is a marker of disease severity and mortality in persons with chronic alcoholic liver disease. Our aims were to assess the utility of the MELD score as a predictor of short-term mortality in persons with alcoholic hepatitis. Methods: We assessed the utility of the MELD score and compared it with the Discriminant Function (DF) as a predictor of mortality in 34 patients hospitalized with alcoholic hepatitis. Results: The area under the curve of a receiver operating characteristic curve for the MELD score was 0.82 (confidence intervals 0.65-0.98), and for the DF was 0.86 (confidence intervals 0.70-1.00). However, the sensitivity and specificity in predicting 30-day mortality for a MELD score of greater than 11 was 86% and 81%, but for a DF greater than 32 was 86% and 48% respectively. The presence of ascites and bilirubin greater than 8 mg/dL were also highly predictive of mortality with a sensitivity of 71% and a specificity of 96%. Conclusions: Alcoholic hepatitis remains associated with a high mortality in hospitalized patients. The MELD score performs as well as the DF in predicting mortality at 30 days. A MELD score of greater than 11, or the presence of both ascites and an elevated bilirubin greater than 8 mg/dL should prompt consideration of specific therapeutic interventions to reduce mortality. © 2002 Sheth et al; BioMed Central Ltd.

引用

页数：5

共 9 条

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