For assessing the severity of alcoholic hepatitis, the American College of Gastroenterology recommends the use of modified Maddrey’s discriminant function (mDF), with a threshold of 32 for considering the corticosteroid therapy.
Recently, the Glasgow alcoholic hepatitis score (GAHS) was shown to be more accurate than mDF in the prediction of outcome from alcoholic hepatitis. Using a GAHS greater than or equal to 9 as the criteria for initiating corticosteroid treatment, better results were obtained.
Thus, among patients with an mDF greater than or equal to 32, there was no appreciable benefit from treatment with corticosteroids in patients with a GAHS less than 9.
In patients with a GAHS greater than or equal to 9, an extremely poor prognosis is expected if the corticosteroid treatment is not started, or if such treatment is contraindicated.
Glasgow alcoholic hepatitis score