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Table 1 Prognostic scoring formulas to determine severity of acute alcoholic hepatitis

From: Prognostic models for alcoholic hepatitis

Scoring system

Formula

Severe Disease

mDF

4.6 (patient’s PT in seconds- control PT in seconds) + total bilirubin (mg/dL)

≥32

 

CTP

1

2

3

  

 Bilirubin

<2 mg/dL

2–3 mg/dL

>3 mg/dL

Class A

5–6 points

 Albumin

>3.5 g/dL

2.8–3.5 g/dL

<2.8 g/dL

Class B

7–9 points

 INR

<1.7

1.7–2.2

>2.2

Class C

10–15 points

 Ascites

None

Mild

Severe

 

 Encephalopathy

None

Grade I-II

Grade III-IV

 

MELD

MELD Score = 0.957 x Loge (creatinine mg/dL) + 0.378 x Loge (bilirubin mg/dL) + 1.120 x Loge (INR) 0.6431* 10 (if hemodialysis, value for Creatinine is automatically set to 4.0)

MELD ≥ 21

MELD score = 3.8*loge (total bilirubin, mg/dL) + 11.2*loge (INR) + 9.6*loge(creatinine, mg/dL)

 

MELD score = 9.57 x loge (Cr mg/dL) + 3.78 x loge (bili mg/dL) + 11.20 x loge (INR) + 6.43

 

MELD-Na

MELD-Na score = MELD Score - Na - 0.025*MELD* (140-Na) + 140

 

GAHS

1

2

3

≥9

 Age

<50

≥50

-

 

 WBC (109/l)

<15

≥15

-

 

 Urea (mmol/l)

<5

≥5

-

 

 PT ratio

<1.5

1.5–2.0

>2.0

 

 Bilirubin (μmol/l)

<125

125 - 250

>250

 

Lille Score

Lille Score = 3.19–0.101 * (age in years) + 0.147 * (albumin day 0 in g/L) + 0.0165 * (evolution in bilirubin level in μM) - (0.206 * renal insufficiency) - 0.0065 * (bilirubin day 0 in μM) - 0.0096 * (INR or prothrombin time in seconds).

≥0.45

ABIC score

ABIC score = (age × 0.1) + (serum bilirubin × 0.08) + (serum creatinine × 0.3) + (INR × 0.8)

>9.0

AHHS

 

Points

 

Stage of fibrosis

 

Mild (0–3)

No fibrosis or portal fibrosis

0

Moderate (4–5)

Expansive fibrosis

0

Severe (6–9)

Bridging fibrosis or cirrhosis

3

Bilirubinostasis

 

No

0

Hepatocellular only

0

Canalicular or ductular

1

Canalicular or ductular plus hepatocellular

2

PMN infiltration

 

No/ Mild

2

Severe

0

Megamitochondria

 

No Megamitochondria

2

Megamitochondria

0

  1. mDF modified Discriminant Function, CTP Child Turcotte Pugh, MELD Model for End-stage Liver Disease, GAHS Glasgow Alcoholic Hepatitis Score, ABIC Age serum Bilirubin INR and serum Creatinine, AHHS Alcoholic Hepatitis Histologic Score
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