Original scientific paper
https://doi.org/10.3325/cmj.2021.62.17
Comparison of prognostic scores for alcoholic hepatitis: a retrospective study
Tonći Božin
; Department of Gastroenterology, Hepatology, and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia
Zrinka Rob
; Department of Gastroenterology, Hepatology, and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia
Marko Lucijanić
; Department of Hematology, Dubrava University Hospital, Zagreb, Croatia
Laura Čmarec Buhin
; Zagreb University School of Medicine, Zagreb, Croatia
Ivica Grgurević
; Zagreb University School of Medicine, Zagreb, Croatia
Abstract
Aim To explore the prognostic value of modified Discriminant Function (mDF), Glasgow Alcoholic Hepatitis Score
(GAHS), Model of End Stage Liver Disease (MELD), AgeBilirubin-International Normalized Ratio-Creatinine score
(ABIC), and the Lille Model for the 28- and 90-day mortality
in patients with alcoholic hepatitis.
Methods This retrospective study enrolled patients treated for alcoholic hepatitis in Dubrava University Hospital
between January 2014 and May 2018. The diagnosis was
established based on histology findings or the combination of patient´s history of ongoing alcohol consumption
before hospitalization, serum bilirubin above 50 mmol/L,
and aspartate transaminase to alanine transaminase ratio greater than 1.5. We calculated mDF, MELD, GAHS, and
ABIC on the first and seventh day of hospitalization (including the Lille model).
Results In total, 70 patients were enrolled. ABIC at admission most accurately predicted the 28-day mortality, with a
cut-off of 9.92 (AUC 0.727; 95% CI 0.608-0.827, P=0.0119),
while GAHS most accurately predicted the 90-day mortality, calculated both at admission (cut off >7, AUC 0.765,
95% CI 0.639-0.864, P<0.0001) and after seven days of
hospitalization (cut-off >8, AUC 0.835 95% CI 0.716-0.918,
P<0.0001). Modified DF was able to predict the 28- and
90-day mortality only when calculated after seven days of
hospitalization.
Conclusion There is a need for better prognostic indicators for patients with AH.
Keywords
Hrčak ID:
278024
URI
Publication date:
25.2.2021.
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