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ABIC score - Stratification of risk of death in AH

Dominguez M, Rincón D, et al. created a scoring system that predicts the risk of death in patients with alcoholic hepatitis (AH) at 90 days and 1 year based on four easily obtained monitoring parameters: Age, serum Bilirubin, INR, and serum Creatinine - (ABIC) score.
This score, along with other scoring systems, has aided in the management of patients with  alcoholic hepatitis. It has also been found to be a useful tool in clinical trials.1

ABIC Score

ABIC Score = (age x 0.1) + (serum bilirubin x 0.08) + (serum creatinine x 0.3) + (INR x 0.8).   Age in years, bilirubin (mg/dL), and creatinine (mg/dL).

ABIC score calculation

Age: (Years)

Serum Total Bilirubin:

[Normal: < 1.2 mg/dL (0.1 -1.2 mg/dL)]

INR:

Serum creatinine:

Background Info

Interpretation:
ABIC cutoff values of 6.71 and 9 were identified as key values in estimating survival rates at 90 days and 1 year.2  There risk groups were created:   ABIC score < 6.71: LOW risk;    ABIC score 6.71 - <9: INTERMEDIATE risk; and finally ABIC score>9: High risk.
Survival rates at 90 days:  Low risk: 100%;  Intermediate risk: 70%;  High risk: 25%.

"A higher ABIC cut-off of 9.5 compared to original cut-off of 9 resulted in an increased specificity of 90 % vs. 80 % and 95 % vs. 84 % for a 30- and 90-day outcome respectively."2

Assessing 1 year mortality with this tool can be used to aid decision making regarding liver  transplantation assignment. 2

Steroid therapy:
"Analysis of the subgroup of patients treated with steroids showed that the greatest response was in the group with intermediate ABIC score (between 6.71–8.99) compared to those with either low ABIC (<6.71) or high ABIC scores (>9). In patients treated with steroids, the ABIC score at 7 days has a better accuracy than the Lille model in predicting mortality at 6 months." 2

References

1. Dominguez M, Rincón D, Abraldes JG, Miquel R, Colmenero J, Bellot P, et al. A new scoring system for prognostic stratification of patients with alcoholic hepatitis. Am J Gastroenterol. 2008;103(11):2747–56.  [Pubmed]

2. Rahimi E, Pan JJ. Prognostic models for alcoholic hepatitis. Biomark Res. 2015;3:20. Published 2015 Jul 21. doi:10.1186/s40364-015-0046-z
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509754/
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