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Model for end-stage liver disease-Na score or Maddrey discrimination function index, which score is best?

Model for end-stage liver disease-Na score or Maddrey discrimination function index, which score is best?

作     者:Mercedes Amieva-Balmori Scherezada María Isabel Mejia-Loza Roberto Ramos-González Felipe Zamarripa-Dorsey Eli García-Ruiz Nuria Pérez y López Eumir I Juárez-Valdés Adriana López-Luria José María Remes-Troche 

作者机构:Servicio de Gastroenterología Instituto de Investigaciones Médico-Biológicas de la Universidad VeracruzanaHospital Juárez de México Laboratorio de Fisiología Digestiva Instituto de Investigaciones Médico-Biológicas de la Universidad Veracruzana 

出 版 物:《World Journal of Hepatology》 (世界肝病学杂志(英文版)(电子版))

年 卷 期:2015年第7卷第17期

页      面:2119-2126页

学科分类:1002[医学-临床医学] 100201[医学-内科学(含:心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主  题:Alcoholic hepatitis Model for end-stageliver disease-Na Maddrey Mortality 

摘      要:AIM: To compare the ability of model for end-stage liver disease(MELD)-Na and Maddrey discrimination function index(DFI) to predict mortality at 30 and 90 d in patients with alcoholic hepatitis(AH).METHODS: We prospectively assessed 52 patients with AH. Demographic, clinical and laboratory parameters were obtained. MELD-Na and Maddrey DFI were calculated on admission. Short-term mortality was assessed at 30 and 90 d. Receiver operating characteristic curve analysis was performed. RESULTS: Thirty-day and 90-d mortality was 44% and 58%, respectively. In the univariate analysis, sodium levels was associated with mortality at 30 and 90 d(P = 0.001 and P = 0.03). Child stage, encephalopathy, ascites, or types of treatment were not associated with mortality. MELD-Na was the only predictive factor for mortality at 90 d. For 30-d mortality area under the curve(AUC) was 0.763(95%CI: 0.63-0.89) for Maddrey DFI and 0.784 for MELD-Na(95%CI: 0.65-0.91, P = 0.82). For 90-d mortality AUC was 0.685(95%CI: 0.54-0.83) for Maddrey DFI and 0.8710 for MELD-Na(95%CI: 0.76-0.97, P = 0.041). CONCLUSION: AH is associated with high shortterm mortality. Our results show that MELD-Na is a more valuable model than DFI to predict short-term mortality.

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