MELD accurately predicts mortality in patients with alcoholic hepatitis

Winston Dunn, Laith H. Jamil, Larry S. Brown, Russell H. Wiesner, W. Ray Kim, K. V Narayanan Menon, Michael Malinchoc, Patrick Sequeira Kamath, Vijay Shah

Research output: Contribution to journalArticle

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Abstract

Assessing severity of disease in patients with alcoholic hepatitis (AH) is useful for predicting mortality, guiding treatment decisions, and stratifying patients for therapeutic trials. The traditional disease-specific prognostic model used for this purpose is the Maddrey discriminant function (DF). The model for end-stage liver disease (MELD) is a more recently developed scoring system that has been validated as an independent predictor of patient survival in candidates for liver transplantation. The aim of the present study was to examine the ability of MELD to predict mortality in patients with AH. A retrospective cohort study of 73 patients diagnosed with AH between 1995 and 2001 was performed at the Mayo Clinic in Rochester, Minnesota. MELD was the only independent predictor of mortality in patients with AH. MELD was comparable to DF in predicting 30-day mortality (c-statistic and 95% CI: 0.83 [0.71-0.96] and 0.74 [0.62-0.87] for MELD and DF, respectively, not significant) and 90-day mortality (c-statistic and 95% CI: 0.86 [0.77-0.96] and 0.83 [0.74-0.92] for MELD and DF, respectively, not significant). A MELD score of 21 had a sensitivity of 75% and a specificity of 75% in predicting 90-day mortality in AH. In conclusion, MELD is useful for predicting 30-day and 90-day mortality in patients with AH and maintains some practical and statistical advantages over DF in predicting mortality rate in these patients. MELD is a useful clinical tool for gauging mortality and guiding treatment decisions in patients with AH, particularly those complicated by ascites and/or encephalopathy.

Original languageEnglish (US)
Pages (from-to)353-358
Number of pages6
JournalHepatology
Volume41
Issue number2
DOIs
StatePublished - Feb 2005

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Alcoholic Hepatitis
End Stage Liver Disease
Mortality
Brain Diseases
Ascites
Liver Transplantation
Cohort Studies
Therapeutics
Retrospective Studies

ASJC Scopus subject areas

  • Hepatology

Cite this

Dunn, W., Jamil, L. H., Brown, L. S., Wiesner, R. H., Kim, W. R., Menon, K. V. N., ... Shah, V. (2005). MELD accurately predicts mortality in patients with alcoholic hepatitis. Hepatology, 41(2), 353-358. https://doi.org/10.1002/hep.20503

MELD accurately predicts mortality in patients with alcoholic hepatitis. / Dunn, Winston; Jamil, Laith H.; Brown, Larry S.; Wiesner, Russell H.; Kim, W. Ray; Menon, K. V Narayanan; Malinchoc, Michael; Kamath, Patrick Sequeira; Shah, Vijay.

In: Hepatology, Vol. 41, No. 2, 02.2005, p. 353-358.

Research output: Contribution to journalArticle

Dunn, W, Jamil, LH, Brown, LS, Wiesner, RH, Kim, WR, Menon, KVN, Malinchoc, M, Kamath, PS & Shah, V 2005, 'MELD accurately predicts mortality in patients with alcoholic hepatitis', Hepatology, vol. 41, no. 2, pp. 353-358. https://doi.org/10.1002/hep.20503
Dunn W, Jamil LH, Brown LS, Wiesner RH, Kim WR, Menon KVN et al. MELD accurately predicts mortality in patients with alcoholic hepatitis. Hepatology. 2005 Feb;41(2):353-358. https://doi.org/10.1002/hep.20503
Dunn, Winston ; Jamil, Laith H. ; Brown, Larry S. ; Wiesner, Russell H. ; Kim, W. Ray ; Menon, K. V Narayanan ; Malinchoc, Michael ; Kamath, Patrick Sequeira ; Shah, Vijay. / MELD accurately predicts mortality in patients with alcoholic hepatitis. In: Hepatology. 2005 ; Vol. 41, No. 2. pp. 353-358.
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