Historically, patients with severe alcoholic hepatitis have been reported to have a 30-day mortality as high as 50%. Thus, the MELD score may be useful as a predictor of mortality in alcoholic hepatitis. Furthermore, the individual components of the MELD score have been described as individual predictors of mortality from alcoholic hepatitis in various studies. The Mayo End Stage Liver Disease (MELD) score is becoming widely used for the prediction of mortality from end-stage liver disease and is a marker of disease severity and predictor of mortality in patients with alcoholic cirrhosis. Indeed, alcoholic hepatitis may be superimposed on chronic hepatic insufficiency or cirrhosis. Persistent alcohol intake may result in collagen deposition around the central vein with central hyaline sclerosis, and eventually result in fibrotic lesions. Thus, the identification of individuals at high risk of mortality is essential for the management of persons presenting with alcoholic hepatitis. Specific therapies such as corticosteroids and pentoxyfilline need to be considered as they may reduce mortality in those patients who are at high risk of dying.

The treatment of alcoholic hepatitis is largely symptomatic, with emphasis on alcohol abstinence and meticulous attention to nutritional status. In severe cases, alcoholic hepatitis is associated with a high mortality. A MELD score of greater than 11, or the presence of both ascites and an elevated bilirubin greater than 8 mg/dL should prompt consideration of specific therapeutic interventions to reduce mortality.Īlcoholic hepatitis is a manifestation of alcoholic liver injury characterized by necrotizing inflammatory hepatic lesions and acute hepatic decompensation. The MELD score performs as well as the DF in predicting mortality at 30 days. ConclusionsĪlcoholic hepatitis remains associated with a high mortality in hospitalized patients. The presence of ascites and bilirubin greater than 8 mg/dL were also highly predictive of mortality with a sensitivity of 71% and a specificity of 96%. However, the sensitivity and specificity in predicting 30-day mortality for a MELD score of greater than 11 was 86% and 81%, but for a DF greater than 32 was 86% and 48% respectively. The area under the curve of a receiver operating characteristic curve for the MELD score was 0.82 (confidence intervals 0.65–0.98), and for the DF was 0.86 (confidence intervals 0.70–1.00). We assessed the utility of the MELD score and compared it with the Discriminant Function (DF) as a predictor of mortality in 34 patients hospitalized with alcoholic hepatitis. Our aims were to assess the utility of the MELD score as a predictor of short-term mortality in persons with alcoholic hepatitis.

The Mayo End-Stage Liver Disease (MELD) score is a marker of disease severity and mortality in persons with chronic alcoholic liver disease. Specific therapies should be considered for those at high risk of mortality. Alcoholic hepatitis is characterized by acute, or acute-on-chronic hepatic failure and associated with a high mortality.

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