Future use of the Glasgow alcoholic hepatitis score

The overall death rate in the study was 23% at 28 days and the death rate of patients with a DFS >32 was 29% at 28 days in the derivation population. The latter figure is lower than the placebo arms of many of the randomised controlled trials of alcoholic hepatitis that range between 35% and 50%.1–3 This difference compared with the published literature may be attributable to case definition. It is possible that there were a fewer number of patients in the derivation cohort for GAHS with true alcoholic hepatitis. Some of the previous studies of alcoholic hepatitis have required liver biopsy evidence of alcoholic hepatitis as part of the case definition. This was not the case for entry into the derivation cohort for the GAHS study and the case definition was based solely on clinical and biochemical evidence of liver dysfunction in patients with heavy alcohol consumption. In the validation population there was biopsy evidence of alcoholic hepatitis in only 33%