Maddrey, MELD, and Glasgow Scores as Predictors of Mortality in Patients with Alcoholic Hepatitis

Alcoholism, in addition to causing multiple social problems, has a significant impact on
health, with alcoholic hepatitis being one of its main complications. OBJECTIVE: The
objective of this study was to compare the MELD, Maddrey, and Glasgow scores as
predictors of 30-day mortality in patients with alcoholic hepatitis hospitalized in the
Department of Internal Medicine between January and December 2023. MATERIAL AND
METHOD: A retrospective observational analytical study was conducted at Roosevelt
Hospital, including 187 adult patients diagnosed with severe alcoholic hepatitis between
January and December 2023. MDF, MELD, and GAHS scores were calculated upon
admission, and hospital and 30-day mortality were recorded. ROC curves were constructed
to estimate the area under the curve (AUC) for each score, and sensitivity, specificity, and
predictive values were calculated. RESULTS: Overall, 30-day mortality was 22.5%. MELD
performed best (AUC 0.77, cutoff point 21.8, sensitivity 76.2%, specifically 70.3%, Youden
index 0.46). GAHS achieved an AUC of 0.74, with a cutoff point of 9.14, sensitivity of
80.9%, specificity of 63.5%, and Youden index of 0.44. Maddrey showed lower predictive
capacity (AUC 0.59, cutoff 28.7, sensitivity 54.8%, specificity 66.2%, Youden 0.21).
CONCLUSIONS: Although all three scores proved useful for predicting mortality, the
MELD score stood out for its greater accuracy and practicality in the prognostic evaluation
of these patients.