[MELD or Maddrey?: comparison of two prognosis models in patients with alcohol toxic hepatitis].

BACKGROUND

The toxic hepatitis is the most common manifestation of acute liver disease in patient with alcohol. In these patients the discriminatory function index (DFI) > 32, has been associated with a mortality rate of up to 50%. MELD is a scale that has been recently validated as independent risk factors for death in patients who are candidates for liver transplantation.

OBJECTIVES

To compare the usefulness in mortality score vs. MELD. Maddrey index of discrimination in patients with alcoholic hepatitis and analyze the factors in a cohort Mexican prognosis.

MATERIALS AND

METHODS

We evaluated the usefulness of MELD, compared with the index of discrimination Maddrey so retrospective in 67 hospitalized patients with alcoholic hepatitis in the Hospital Juárez in Mexico.

RESULTS

The c-statistic for mDFI was 0.69 (CI 0.56-0.82) and to MELD was 0.73 (CI 0.61-0.86), sensitivity and specificity of DFI > 32 in 7 days to predict mortality was 100 and 7.1% , Respectively, and to meld > 21 sensitivity was 96% and specificity of 9.5%. The presence of encephalopathy > grade 2 and creatinine > 1.5 mg/dL was independent predictors of mortality.

CONCLUSIONS

MELD > 21 calculated on admission, is equally useful for the mDFI for predicting mortality in patients with alcoholic hepatitis in the first week.