The Cardiovascular
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Glasgow Alcoholic Hepatitis Score (GAHS)

Glasgow Alcoholic Hepatitis Score (GAHS)
Age
White cell count
Blood urea
INR (or prothrombin time ratio)
Serum bilirubin
Result5 points

GAHS <9 is associated with better untreated survival.

GAHS (5-12)
5

When to use

  • Prognosticating alcoholic hepatitis and identifying patients likely to benefit from corticosteroids.

Formula

Points (1-3) for age, WBC, urea, INR, and bilirubin; total 5-12. Age <50 = 1 / >=50 = 2; WBC <15 = 1 / >=15 = 2; urea <5 = 1 / >=5 = 2; INR <1.5 = 1 / 1.5-2.0 = 2 / >2.0 = 3; bilirubin <125 = 1 / 125-250 = 2 / >250 = 3.

Pearls and pitfalls

  • GAHS was designed to refine steroid selection among patients already identified as severe by a Maddrey discriminant function >=32.

References

  1. Forrest EH, et al. Gut. 2005;54(8):1174-9.