Prognostic and diagnostic scoring models in acute alcohol-associated hepatitis: A review comparing the performance of different scoring systems

Table 2 Alcohol-associated hepatitis prognostic scores: Components, purpose, clinical application and interpretation

Clinical score	Components	Purpose	Clinical application	Interpretation
MELD	INR, bilirubin (total), Creatinine, Sodium	Assess severity of liver disease and predict short-term mortality	Calculate on initial presentation	MELD ≥ 20 = severe AAH
Maddrey Discriminant function	PT (measured and control), bilirubin (total)	Assess severity and prognosis of alcoholic hepatitis	Calculate on initial presentation	MDF ≥ 32 = severe AAH
GAHS	Age, WBC, BUN, Bilirubin, PT (measured and control)	Assess severity and prognosis of alcoholic hepatitis	Calculate on initial presentation	GAHS ≥ 9 = severe AAH
ABIC	Age, bilirubin, INR, PT (measured and control)	Assess prognosis of alcoholic hepatitis in patients on steroid therapy	Use in patients on steroid therapy	< 6.71 low mortality risk; 6.71-8.99 intermediate mortality risk; ≥ 9.00 high mortality risk
Lille score	Age, bilirubin (initial, and day 4 OR day 7), albumin, creatinine, PT	Assess response to corticosteroid therapy in patients with alcoholic hepatitis	Use in patients on steroid therapy, at day 4 and/or day 7 to assess response and indication to continue steroids	< 0.45 at day 4-7 = favorable response to steroid therapy; > 0.45 at day 4-7 = little/no response to steroid therapy
Alcoholic hepatitis histological score	Histologic features of liver injury	Assess severity and prognosis of alcoholic hepatitis	Calculate on biopsy based on: Fibrosis stage, bilirubinostasis, polymorphonuclear infiltration, and megamitochondria	0-3: Mild AAH; 4-5: Moderate AAH; 6-9: Severe AAH

MELD: Model for end-stage liver disease; INR: International normalized ratio; BUN: Blood urea nitrogen; WBC: White blood cells; MDF: Maddrey discriminant function; AAH: Alcohol-associated hepatitis; PT: Prothrombin time; GAHS: Glasgow alcoholic hepatitis score; ABIC: Age-bilirubin-INR-creatinine score.