The Cardiovascular
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Maddrey’s discriminant function

Severity of alcohol-associated hepatitis and likely benefit from steroids.

Maddrey’s discriminant function
Patient prothrombin time
sec
Control prothrombin time
sec
Total bilirubin
mg/dL
Complete the fields above to see the result.

When to use

  • Identifying severe alcohol-associated hepatitis (DF ≥32) in whom corticosteroid therapy may reduce short-term mortality.

Formula

DF = 4.6 × (patient PT − control PT) + total bilirubin (mg/dL).

Pearls and pitfalls

  • Reassess steroid responders with the Lille score at day 7; the DF selects candidates, it does not confirm benefit.

References

  1. Maddrey WC, et al. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978;75(2):193–9.