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Alcoholic Hepatitis Histologic Score (AHHS) of Altamirano et al

Description

Altamirano et al developed a histologic score for evaluating a patient with alcoholic hepatitis. The Alcoholic Hepatitis Histologic Score (AHHS) is associated with prognosis. The authors are from multiple institutions in Europe, Canada and the United States.


Patient selection: alcoholic hepatitis

 

Parameters:

(1) stage of fibrosis

(2) bilirubinostasis

(3) polymorphonuclear (PMN) infiltrate

(4) megamitochondria

 

Parameter

Finding

Points

stage of fibrosis

none

0

 

expansive

0

 

bridging fibrosis or cirrhosis

3

bilirubinostasis

none

0

 

within hepatocytes only

0

 

canalicular or ductulat

1

 

hepatocellular plus canalicular/ductular

2

PMN infiltrate

none or mild

2

 

severe

0

megamitochondria

absent

2

 

present

0

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 9

• The higher the score the more severe the alcoholic hepatitis.

 

Total Score

Severity

90-Day Survival

0 to 3

mild

97-100%

4 or 5

intermediate

81-83%

6 to 9

severe

49-65%

 

Performance:

• The area under the ROC curve was 0.77.


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