What is the Glasgow Alcoholic Hepatitis Score?

GAHS is a 5-variable clinical scoring system developed to predict 28-day and 84-day survival in patients with alcoholic hepatitis. It uses age, BUN, PT ratio, bilirubin, and WBC. Age, BUN, and WBC score 1–2 while PT ratio and bilirubin score 1–3, giving a total of 5–12.

What score threshold indicates poor prognosis?

A GAHS ≥9 is associated with poor 28-day survival (roughly 52% without treatment) and is generally used as the cutoff to consider corticosteroid therapy such as prednisolone.

How does GAHS compare to Maddrey's Discriminant Function?

Both tools predict short-term mortality in alcoholic hepatitis, but GAHS uses five variables and was specifically validated against a UK cohort. Studies suggest GAHS may have better specificity for identifying patients unlikely to benefit from steroids.

What units does this calculator use?

BUN is in mmol/L (SI units), bilirubin in µmol/L, and WBC in ×10⁹/L. PT ratio is unitless (patient PT ÷ control PT). Convert from mg/dL if needed: BUN mmol/L = mg/dL × 0.357; bilirubin µmol/L = mg/dL × 17.1.

Is this tool a substitute for clinical judgment?

No. GAHS is a clinical aid, not a definitive treatment guide. Always interpret results in the context of the full clinical picture and current guidelines.

Glasgow Alcoholic Hepatitis Score Calculator

Enter five clinical values to calculate GAHS and get a 28-day survival estimate for alcoholic hepatitis.

Patient Values

Age (years)

Blood Urea Nitrogen (BUN) (mmol/L)

mg/dL → mmol/L: multiply by 0.357

PT Ratio (patient PT ÷ control PT)

Serum Bilirubin (µmol/L)

mg/dL → µmol/L: multiply by 17.1

WBC Count (×10⁹/L)

Result

—

GAHS Total

Variable	Value	Points

Scoring Criteria

Variable	1 pt	2 pts	3 pts
Age (years)	<50	≥50	—
BUN (mmol/L)	<5	≥5	—
PT Ratio	<1.5	1.5–2.0	>2.0
Bilirubin (µmol/L)	<125	125–250	>250
WBC (×10⁹/L)	<15	≥15	—

Score range: 5–12. A score ≥9 predicts poor 28-day survival (~52%) and supports consideration of corticosteroid therapy.

Survival Reference (Forrest et al., 2005)

GAHS	28-day survival	84-day survival
<9	87%	79%
≥9	52%	38%

Summary

The Glasgow Alcoholic Hepatitis Score (GAHS) predicts 28-day survival in patients with alcoholic hepatitis using five laboratory and clinical variables: age, blood urea nitrogen, PT ratio, serum bilirubin, and white blood cell count. Age, BUN, and WBC each contribute 1–2 points while PT ratio and bilirubin contribute 1–3 points, totalling between 5 and 12. A score of 9 or above identifies patients with a significantly higher risk of early death and is used to guide the decision to initiate corticosteroid therapy.

How it works

Enter the patient age in years.
Enter blood urea nitrogen (BUN) in mmol/L.
Enter the PT ratio (patient PT divided by control PT).
Enter serum bilirubin in µmol/L.
Enter white blood cell count (WBC) in ×10⁹/L.
The score is computed instantly; score ≥9 suggests corticosteroid therapy.

Use cases

Assess 28-day mortality risk in patients admitted with alcoholic hepatitis.
Identify candidates for corticosteroid therapy (GAHS ≥9).
Triage severity in emergency or hepatology settings.
Support clinical decision-making alongside Maddrey Discriminant Function.
Track score changes over the first days of admission.
Educate medical students on prognostic scoring in liver disease.

Frequently Asked Questions

Last updated: 2026-06-11 · Reviewed by Nham Vu