This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
Severe alcoholic hepatitis is an acute inflammation of the liver in people with heavy alcohol use, with jaundice and a high risk of death in the following months. The ABIC score, developed in Barcelona by Dominguez and colleagues in 2008, estimates 90-day survival from four routine values: Age, Bilirubin, INR and Creatinine.
The formula
ABIC = age × 0.1 + bilirubin (mg/dL) × 0.08 + creatinine (mg/dL) × 0.3 + INR × 0.8
To convert from SI units, divide bilirubin in µmol/L by 17.1 and creatinine in µmol/L by 88.4.
Risk groups
| ABIC | Risk | 90-day survival (derivation study) |
|---|---|---|
| under 6.71 | low | 100% |
| 6.71 to 8.99 | intermediate | about 70% |
| 9 or more | high | about 25% |
Example
A 50-year-old with a bilirubin of 10 mg/dL, a creatinine of 1.0 mg/dL and an INR of 1.8 has an ABIC score of 5 + 0.8 + 0.3 + 1.44 = 7.54: intermediate risk, with about 70% survival at 90 days in the original cohort.
Where ABIC fits
Several scores assess alcoholic hepatitis:
- Maddrey discriminant function: 32 or more defines severe disease and has long been the threshold for corticosteroids.
- MELD: above about 20 to 21 indicates severe disease.
- Glasgow alcoholic hepatitis score: 9 or more identifies patients who may benefit from steroids.
- ABIC: three risk groups for prognosis.
- Lille model: measured after 7 days of steroids, it tells whether the treatment is working.
ABIC performs about as well as MELD and the Glasgow score for predicting survival and was also used to select patients in treatment trials.
Beyond the scores
Stopping alcohol completely is the factor that most improves long-term survival, and support from addiction specialists should start in hospital. Nutrition, the prevention and treatment of infection and kidney failure, and, in selected patients who do not respond to treatment, early liver transplantation are discussed with a hepatology team.