The management of alcoholic hepatitis: a prospective comparison of scoring systems

• Published in: Alimentary pharmacology & therapeutics 2013-09, Vol.38 (6), p.603-610
• Main Authors: Lafferty, H., Stanley, A. J., Forrest, E. H.
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Aged, 80 and over; Bilirubin - blood; Biological and medical sciences; Blood Proteins - therapeutic use; Gastroenterology. Liver. Pancreas. Abdomen; Glucocorticoids - therapeutic use; Hepatitis A virus; Hepatitis, Alcoholic - drug therapy; Hepatitis, Alcoholic - physiopathology; Human viral diseases; Humans; Infectious diseases; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Middle Aged; Other diseases. Semiology; Pentoxifylline - therapeutic use; Prognosis; Prospective Studies; ROC Curve; Severity of Illness Index; Treatment Outcome; Viral diseases; Viral hepatitis; Young Adult
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.12414

Summary Background The assessment of alcoholic hepatitis remains controversial. Several scores have been developed or used for this purpose. Aim To study the use of the Glasgow Alcoholic Hepatitis Score (GAHS), the Discriminant Function (DF), Model for End‐Stage Liver Disease (MELD) and the ABIC (age, bilirubin, INR and creatinine) scores as well as scores to assess corticosteroid response in the management of alcoholic hepatitis. Methods A total of 182 patients were studied prospectively. The GAHS, MELD, ABIC and DF scores were recorded on admission and serially over the first week of hospital management. Treatment with corticosteroids or pentoxifylline was considered if the GAHS was ≥9. Results There were no differences in outcome between favourable scores as per recommended cut‐off points. Patients with a GAHS