Système gastro-intestinal et digestif

Abstrait

A Comparison of Prognostic Scoring Systems in Turkish Alcoholic Hepatitis Patients

Fatih Tekin, Zeki Karasu, Elvan Isik Erdogan, Fulya Gunsar, Galip Ersoz, Omer Ozutemiz, Ulus Akarca

Objective: There is a lack of data concerning Turkish patients with alcoholic hepatitis (AH). The aims of the present study were to present the clinical characteristics of hospitalized AH patients and to compare the predictive ability of Maddrey’s discriminant function (DF) score, Model for End-Stage Liver Disease (MELD) score, Glasgow AH (GAHS) score and age, bilirubin, International Normalized Ratio (INR), and creatinine (ABIC) score on in-hospital mortality.
Methods: The DF score and clinical data of 34 patients with AH admitted from 2008 to 2014 were reviewed from patient’s files. Scores for MELD, GAHS and ABIC were then retrospectively calculated. A comparison of scores was obtained using area under the receiver operating characteristics curves to predict in-hospital mortality.
Results: In-hospital mortality was calculated at 23.5% (8/34). Treatment with corticosteroids and/or pentoxifylline was started in 18 patients with DF score ≥ 32; however, seven of them died (7/18, 39%). No significant differences were found between DF, MELD, GAHS and ABIC scores for predicting in-hospital mortality (p>0.05).
Conclusion: DF score, which is easier and more practical, can be used in clinical practice to predict in-hospital mortality because other scores have no statistical superiority. The response to corticosteroid and/or pentoxifylline treatment in patients with a DF score ≥ 32 was poor in Turkish AH patients.