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Abstract: Objective To explore the clinical features and short-term (12 weeks) prognosis of patients with
severe alcoholic hepatitis (SAH). Methods Total of 327 patients with SAH from January 2012 to December
2015 in 302 Military Hospital of China were included in this prospective study. The clinical features of the
patients were obtained. According to the prognosis, patients were divided into survival group (219 cases)
and death group (108 cases), the baselines of two groups were compared. Multivariate Logistic regression
analysis was applied for selecting the risk factors of short-term prognosis. Receiver operating characteristic
(ROC) curve were used to assess the predictive value of Model for end-stage liver disease (MELD) and
Maddrey discriminant function (MDF) for the short-term prognosis of patients with SAH. Results The
MDF and MELD scores in patients with SAH were 64.0 ± 38.5 and 19.1 ± 8.4, respectively. The baseline of
MELD scores and MDF scores were positively correlated (r = 0.662, P = 0.000). The fatality rate of patients
with SAH in 12 weeks was 33.0%, and with the MDF and MELD scores increasing, the fatality rate showed
upward trends. In death group, the average age was (49.6 ± 10.2) years old, the levels of AST, GGT, TBil,
D/T, PT, INR, CRE, WBC and NE were 79.0 U/L, 69.0 U/L, (320.9 ± 161.7) μmol/L, 0.71 ± 0.10, 2.4 ±
1.0, (200.0 ± 131.3) μmol/L, (29.1 ± 11.8) s, (15.3 ± 11.0) × 10 9 /L and (12.6 ± 10.1) × 10 9 /L, respectively;
the scores of MELD and MDF were 25.8 ± 8.1 and 88.3 ± 54.0, respectively. In survival group, the average
age was (46.2 ± 8.1) years old, the levels of AST, GGT, TBil, D/T, PT, INR, CRE, WBC and NE were 54.0 U/L,
35.0 U/L, (189.2 ± 122.4) μmol/L, 0.65 ± 0.13, (22.9 ± 3.8) s, 1.9 ± 0.3, (98.3 ± 61.7) μmol/L, (6.6 ± 4.9) ×
10 9 /L and (4.6 ± 4.5) × 10 9 /L, respectively; the scores of MELD and MDF were 15.6 ± 5.2 and 52.0 ± 18.5,
respectively. The indexes above in death group were higher than those of survival group, the differences were
statistically significant (P ＜ 0.001). The levels of TBA, PTA and HGB in survival group were higher than
those of death group [(185.5 ± 98.1) μmol/L vs (154.2 ± 104.6) μmol/L, (36.7 ± 7.4)% vs (30.7 ± 12.2)%, (90.4 ±
21.3) g/L vs (81.6 ± 27.5) g/L], the differences were statistically significant (t = 2.621, 5.523 and 3.188; P ＜
0.05). Multivariate Logistic regression analysis showed that MELD, HGB and age were the independent risk
factors to predict the short-term prognosis of patients with SAH. ROC curve showed that the area under the
curve of MELD and MDF were 0.859 and 0.744. The predictive value of MELD about short-term prognosis
of patients with SAH were better than that of MDF (Z = -3.068, P = 0.002). Conclusions The condition and
short-term prognosis of patients with SAH were poor. MELD can better assess the short-term prognosis of
patients with SAH than MDF.
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