Which five variables go into the score?

Age (50 or under scores 1, over 50 scores 2), white cell count (15 x10^9/L or under scores 1, above scores 2), urea (5 mmol/L or under scores 1, above scores 2), prothrombin ratio (1.5 or under scores 1, 1.5 to 2 scores 2, above 2 scores 3) and bilirubin (125 umol/L or under scores 1, 125 to 250 scores 2, above 250 scores 3). The total runs from 5 to 12.

When should the score be repeated?

The original derivation measured it on admission and again between days 6 and 9. A score that stays at 9 or above on the repeat carries a markedly worse prognosis and is the group in which steroid benefit is clearest. A falling score is a favourable sign even if treatment has not changed.

How does it relate to the Maddrey discriminant function?

Both select patients for steroids and perform similarly, with sensitivity near 78-80% at their usual cut-offs (GAHS 9, Maddrey 32). Many units use either threshold, and some use both so that a patient positive on one is not missed.

Glasgow Alcoholic Hepatitis Score: Day 1 and Day 6-9

The Glasgow alcoholic hepatitis score (Forrest et al., 2005) combines age, white cell count, urea, prothrombin ratio and bilirubin into a 5-12 point scale. A score of 9 or more identifies the patients whose 28-day mortality falls with corticosteroids.

Five parameters, each scored 1–3, total 5–12. A score ≥ 9 indicates severe disease. Source: Forrest et al., Gut 2005;54(8):1174–1179.

Age (years)

White cell count (×10⁹/L)

Urea (mmol/L)

Prothrombin time ratio

Bilirubin (µmol/L)

5/ 12

GAHS 5 — not in the severe range

Parameter	Value	Points
Age	48 y	1
White cell count	12 ×10⁹/L	1
Urea	4 mmol/L	1
Prothrombin time ratio	1.2	1
Bilirubin	100 µmol/L	1
Total		5

Parameter	1	2	3
Age (y)	<50	≥50	—
WCC (×10⁹/L)	<15	≥15	—
Urea (mmol/L)	<5	≥5	—
PT ratio	<1.5	1.5–2.0	>2.0
Bilirubin (µmol/L)	<125	125–250	>250

Clinical Guidance

The GAHS combines five routine parameters — age, white cell count, urea, prothrombin time ratio, and bilirubin — each scored 1 to 3, for a total of 5 to 12. A score of 9 or more identifies severe alcoholic hepatitis with a poor prognosis and marks patients likely to benefit from corticosteroid therapy.

The score was derived and validated by Forrest and colleagues (Gut 2005) and is used alongside clinical assessment and the Maddrey discriminant function. This calculator is an educational aid and does not replace clinical judgement.

How It Works

Each component has a specific meaning:

Age — The age recorded for the scenario being assessed.
White cell count — The white cell count recorded for the scenario being assessed.
Urea — The urea recorded for the scenario being assessed.
Prothrombin ratio — The prothrombin ratio recorded for the scenario being assessed.
Bilirubin into a 5-12 point scale — The bilirubin into a 5-12 point scale recorded for the scenario being assessed.

Note: Interpret the gahs score result against the thresholds and context described above.

How to Use

Enter the age, white cell count, urea, prothrombin ratio, bilirubin into a 5-12 point scale for the scenario you are assessing. The Glasgow alcoholic hepatitis score (Forrest et al., 2005) combines age, white cell count, urea, prothrombin ratio and bilirubin into a 5-12 point scale. A score of 9 or more identifies the patients whose 28-day mortality falls with corticosteroids. Use the gahs score result to inform your calculation.

Related Calculators

Maddrey DF

Medical

Lille Model AH

Medical

Child-Pugh Score

Medical

Glasgow Alcoholic Hepatitis Score: Day 1 and Day 6-9

How It Works

How to Use

Related Calculators

Frequently Asked Questions

Which five variables go into the score?

When should the score be repeated?

How does it relate to the Maddrey discriminant function?