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KMID : 0614620070490020093
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Korean Journal of Gastroenterology
2007 Volume.49 No. 2 p.93 ~ p.99
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Comparison of Model for End-stage Liver Disease Score with Discriminant Function and Child-Turcotte-Pugh Scores for Predicting Short-term Mortality in Korean Patients with Alcoholic Hepatitis
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Jeong Jae-Yoon
Sohn Joo-Hyun
Sohn Byong-Kwan
Paik Chang-Hee
Kim Seok-Hwan
Han Dong-Soo
Jeon Yong-Chul
Lee Min-Ho
Lee Dong-Hoo
Kee Choon-Suk
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Abstract
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Background/Aims: Alcoholic hepatitis is an acute or acute-on-chronic inflammatory syndrome associated with significant morbidity and mortality. Traditionally, Maddrey discriminant function (DF) score and Child-Turcott-Pugh (CTP) score have been used for stratifying the prognosis of alcoholic hepatitis. Recently, the model for end-stage liver disease (MELD) score has been applied to alcoholic hepatitis and some investigators consider MELD score as a better prognostic indicator for severe alcoholic hepatitis. Therefore, this analysis was aimed to compare MELD score with DF and CTP scores for predicting the short-term mortality in Korean patients with alcoholic hepatitis.
Methods: The medical records of patients hospitalized with alcoholic hepatitis between January 1, 1999 and December 31, 2004 at Hanyang University Guri-Hospital were analyzed retrospectively.
Results: Of the 138 medical records reviewed, 74 cases fulfilled the inclusion criteria (61 males and 13 females; mean age 47.1 years). Twelve patients (16.2%) died within 90 days after admission. Univariate analysis demonstrated that variables such as ascites, hepatic encephalopathy, splenomegaly, international normalized ratio, CTP, and DF scores were significantly correlated with increased 90-day mortality while MELD score was not. According to the multivariate analysis, only CTP score was statistically significant (p=0.012) while DF and MELD scores were not significant for predicting 90-day mortality. The survival analysis with Cox regression test showed higher DF and CTP scores, but not MELD score, significantly increased the risk of in-hospital mortality.
Conclusion: This study demonstrates that DF and CTP scores are independent predictors of short-term mortality in patients with alcoholic hepatitis. (Korean J Gastroenterol 2007;49:93-99)
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KEYWORD
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Alcoholic hepatitis, Mortality, Prognosis
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