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.
Alcohol-associated hepatitis is an acute inflammation of the liver in people with heavy, prolonged drinking. It typically causes jaundice, fever and a tender, enlarged liver, and severe forms carry a high short-term risk of death. The Glasgow alcoholic hepatitis score (GAHS), published by Forrest and colleagues in 2005, grades that risk with five routine measurements.
The score
| Variable | 1 point | 2 points | 3 points |
|---|---|---|---|
| Age | under 50 | 50 or more | |
| White cells (×10³/µL) | under 15 | 15 or more | |
| Urea (mmol/L) | under 5 | 5 or more | |
| INR or PT ratio | under 1.5 | 1.5 to 2.0 | above 2.0 |
| Bilirubin (µmol/L) | under 125 | 125 to 250 | above 250 |
The total runs from 5 to 12. US labs report blood urea nitrogen in mg/dL and bilirubin in mg/dL: the calculator converts BUN by dividing by 2.8, and bilirubin by multiplying by 17.1.
Example
A 52-year-old with white cells at 16, BUN 17 mg/dL (6.1 mmol/L), INR 1.8 and bilirubin 9 mg/dL (154 µmol/L) gets 2 points for each variable: a GAHS of 10.
Interpretation
In the original Glasgow cohort, 28-day survival was about 87% with a score under 9 and about 46% with a score of 9 or more. The score is often used with the Maddrey discriminant function: in patients with a Maddrey score of 32 or more, a GAHS of 9 or more identified those who appeared to benefit from corticosteroids, although later trials have made that benefit less certain.
Related scores
- Maddrey discriminant function: the oldest score, based on prothrombin time and bilirubin.
- MELD: used across liver disease and for transplant listing.
- Lille model: measures the response to steroids after seven days.
Limits
- The GAHS was derived in a UK population; cut-offs may differ elsewhere.
- Infection, bleeding and kidney failure strongly affect outcome and need their own assessment.
- It supports, but does not replace, the clinical judgment of the treating team.
Stopping alcohol completely is the single most important factor for long-term survival. Support is available from your doctor and from free helplines such as the SAMHSA National Helpline (1-800-662-4357).