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M odel for E nd‐ S tage L iver D isease score versus M addrey D iscriminant F unction score in assessing short‐term outcome in alcoholic hepatitis
Author(s) -
Kadian Monil,
Kakkar Rajesh,
Dhar Minakshi,
Kaushik Rajeev Mohan
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12400
Subject(s) - medicine , confidence interval , concordance , gastroenterology , interquartile range
Background and Aims The M addrey D iscriminant F unction ( mDF ) score and the M odel for E nd‐ S tage L iver D isease ( 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 H imalayan I nstitute H ospital, D ehradun, I ndia 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.