摘要Background:Early identification of patients with high mortality risk is critical for optimizing the clinical management of drug-induced liver injury(DILI).We aimed to develop and validate a new prognostic model to predict death within 6 months in DILI patients.Methods:This multicenter study retrospectively reviewed the medical records of DILI patients admitted to three hospitals.A DILI mortality predictive score was developed using multivariate logistic regression and was validated with area under the receiver operating characteristic curve(AUC).A high-mortality-risk subgroup was identified according to the score.Results:Three independent DILI cohorts,including one derivation cohort(n=741)and two validation co-horts(n=650,n=617)were recruited.The DILI mortality predictive(DMP)score was calculated using parameters at disease onset as follows:1.913 × international normalized ratio+0.060 × total biliru-bin(mg/dL)+0.439 × aspartate aminotransferase/alanine aminotransferase-1.579 × albumin(g/dL)-0.006 × platelet count(109/L)+9.662.The predictive performance for 6-month mortality of DMP score was desirable,with an AUC of 0.941(95％CI:0.922-0.957),0.931(0.908-0.949)and 0.960(0.942-0.974)in the derivation,validation cohorts 1 and 2,respectively.DILI patients with a DMP score ≥ 8.5 were strat-ified into high-risk group,whose mortality rates were 23-,36-,and 45-fold higher than those of other patients in the three cohorts.Conclusions:The novel model based on common laboratory findings can accurately predict mortality within 6 months in DILI patients,which should serve as an effective guidance for management of DILI in clinical practice.