Gastroenterology

Maddrey's Discriminant Function

Assesses severity of alcoholic hepatitis and indication for steroids.

Parameters

seconds
seconds
mg/dL

Maddrey's Discriminant Function Result

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FormulamDF = 4.6 × (Patient PT - Control PT) + Total Bilirubin (mg/dL)

Clinical Pearls

A DF score of 32 or higher predicts a 50% mortality during the current admission and is the threshold to initiate corticosteroid therapy.

Limitations

The score heavily weights PT, which can vary significantly depending on the lab and the specific thromboplastin reagent used. The Lille score is often used on day 7 to see if steroids should be continued.