title: A new scoring system for prognostic stratification of patients with alcoholic hepatitis.
abstract: OBJECTIVE
  Prognostic stratification of patients with alcoholic hepatitis (AH) may improve the clinical management and facilitate clinical trials. We aimed at developing a scoring system capable of providing prognostic stratification of patients with AH.
  
  
  METHODS
  Patients with biopsy-proven AH were prospectively included between 2000 and 2006. The biochemical, clinical, portal hemodynamic and histological parameters were evaluated. A Cox regression model was used for univariate and multivariate analyses. A predictive score was built using variables obtained at admission identified in the multivariate analysis. The resulting score was validated in an independent prospective cohort.
  
  
  RESULTS
  In total, 103 patients with biopsy-proven AH were included in the study cohort. Age, serum bilirubin, serum creatinine, and international normalized ratio (INR) independently predicted 90-day mortality. We generated the Age, serum Bilirubin, INR, and serum Creatinine (ABIC) score: (age x 0.1) + (serum bilirubin x 0.08) + (serum creatinine x 0.3) + (INR x 0.8). The area under the curve (AUC) was 0.82. Using the Kaplan-Meier analysis with the cutoff values of 6.71 and 9.0, we identified patients with low, intermediate, and high risk of death at 90 days (100%, 70%, and 25% of survival rate, respectively). Using the same cutoff values, the ABIC score also stratified patients according to their risk of death at 1 yr. These results were validated by a confirmatory cohort (N = 80).
  
  
  CONCLUSIONS
  The ABIC score is a new tool that allows the stratification of risk of death in patients with AH at 90 days and 1 yr. This score can help improve the management of these patients and also help to perform clinical trials.
authors: Liver Unit, Institut Clínic Malalties Digestives i Metabòliques, Hospital Clinic, and Centro de Investigación Biomédica Esther Koplowitz, Barcelona, Catalonia, Spain.
authors: Marlene
authors: M
authors: Dominguez
authors: Diego
authors: D
authors: Rincón
authors: Juan G
authors: JG
authors: Abraldes
authors: Rosa
authors: R
authors: Miquel
authors: Jordi
authors: J
authors: Colmenero
authors: Pablo
authors: P
authors: Bellot
authors: Joan-Carles
authors: JC
authors: García-Pagán
authors: Rosamelia
authors: R
authors: Fernández
authors: Montserrat
authors: M
authors: Moreno
authors: Rafael
authors: R
authors: Bañares
authors: Vicente
authors: V
authors: Arroyo
authors: Joan
authors: J
authors: Caballería
authors: Pere
authors: P
authors: Ginès
authors: Ramón
authors: R
authors: Bataller
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006519:Hepatitis, Alcoholic / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index