Maddrey's Discriminant Function Calculator
Calculate Maddrey's Discriminant Function to assess severity and prognosis of alcoholic hepatitis
Calculate Maddrey's Discriminant Function
Patient's actual prothrombin time in seconds
Laboratory reference PT (typically 11-13 seconds)
Total serum bilirubin concentration (normal: 0.1-1.2 mg/dL or 1.7-20.5 µmol/L)
Maddrey's Discriminant Function Results
Score Analysis
Example Calculation
Patient with Severe Alcoholic Hepatitis
Patient PT: 20.5 seconds
Reference PT: 12.0 seconds
Total Bilirubin: 8.2 mg/dL
Calculation
MDF = 4.6 x (20.5 - 12.0) + 8.2
MDF = 4.6 x 8.5 + 8.2
MDF = 39.1 + 8.2
MDF = 47.3 (Poor prognosis - consider steroids)
Corticosteroid Therapy Guidelines
Indications
MDF >= 32 AND no contraindications
Dosing
Prednisolone 40mg daily for 28 days
Contraindications
- • Active infection
- • Gastrointestinal bleeding
- • Renal failure
- • Pancreatitis
Mortality Risk
28-day mortality rates for alcoholic hepatitis patients
Normal Values
Understanding Maddrey's Discriminant Function
What is Maddrey's Discriminant Function?
Maddrey's Discriminant Function (MDF) is a prognostic scoring system developed in 1978 to assess the severity of alcoholic hepatitis and identify patients who would benefit from corticosteroid therapy.
Clinical Applications
- •Risk stratification of alcoholic hepatitis patients
- •Guide corticosteroid therapy decisions
- •Predict short-term mortality (28-day)
- •Monitor treatment response
Formula Components
MDF = 4.6 x (PT - reference PT) + bilirubin
- PT: Patient's prothrombin time (seconds)
- Reference PT: Laboratory control PT (11-13s)
- Bilirubin: Total bilirubin (mg/dL)
- 4.6: Empirical weighting factor
Critical Threshold: MDF >= 32 indicates severe disease requiring consideration of corticosteroid therapy
Alcoholic Hepatitis Overview
Alcoholic hepatitis is a severe form of acute liver injury caused by heavy alcohol consumption. It typically affects young and middle-aged adults and is associated with significant morbidity and mortality.
Symptoms
- • Jaundice (yellowing of skin/eyes)
- • Abdominal pain and swelling
- • Fatigue and weakness
- • Loss of appetite
- • Weight loss
- • Fever
Treatment Options
- • Complete alcohol cessation
- • Nutritional support
- • Corticosteroids (prednisolone)
- • Pentoxifylline (alternative)
- • N-acetylcysteine (adjunctive)
- • Liver transplantation (severe cases)