The Utility of Scoring Systems in Predicting Early and Late Mortality in Alcoholic Hepatitis : Whose Score Is It Anyway?

Abstract EN

Background.

Alcoholic hepatitis (AH) is a distinct clinical entity in the spectrum of alcoholic liver disease with a high short-term mortality.

Several scoring systems are being used to assess the severity of AH but the ability of these scores to predict long-term survival in these patients is largely unknown.

Aims.

We aim to assess the utility of five different scoring systems Child Pugh (CP), model for end-stage liver disease (MELD), Maddrey’s discriminant function (mDF), Glasgow AH score (GAHS), and age-bilirubin-INR-creatinine (ABIC) score in predicting shot-term and long-term survival in patients with AH.

Methods.

Patients with histological evidence of AH were identified from our database.

The clinical and biochemical parameters were used to calculate the 5 different scores.

The prognostic utility of these scores was determined by generating an ROC curve for survival at 30 days, 90 days, 6 months, and 1 year.

Results and Conclusions.

All 5 scores with the exception of CP score have a similar accuracy in predicting the short-term prognosis.

However, they are uniformly poor in predicting longer-term survival with AUROC not exceeding 0.74.

CP score is a very poor predictor of survival in both short and long term.

Abstinence from alcohol was significantly (P<0.05) associated with survival at 1 year.