Evaluation of MELD score and Maddrey discriminant function for mortality prediction in patients with alcoholic hepatitis.

Abstract

Maddrey discriminant function (DF) is the traditional model for evaluating the severity and prognosis in alcoholic hepatitis (AH). However, MELD has also been used for this purpose. We aimed to determine the predictive parameters and compare the ability of Maddrey DF and MELD to predict short-term mortality in patients with AH. Retrospective study of 45 patients admitted in our department with AH between 2000 and 2010. Demographic, clinical and laboratory parameters were collected. MELD and Maddrey DF were calculated on admission. Short-term mortality was assessed at 30 and 90 days. Student t-test, χ2 test, univariate analysis, logistic regression and receiver operating characteristic curves were performed. Thirty-day and 90-day mortality was 27% and 42%, respectively. In multivariate analysis, Maddrey DF was the only independent predictor of mortality for these two periods. Receiver operating characteristic curves for Maddrey DF revealed an excellent discriminatory ability to predict 30-day and 90-day mortality for a Maddrey DF greater than 65 and 60, respectively. Discriminatory ability to predict 30-day and 90-day mortality for MELD was low. AH remains associated with a high short-term mortality. Maddrey DF is a more valuable model than MELD to predict short-term mortality in patients with AH.