Maddrey Discriminant Function (Alcoholic Hepatitis)
Predicts 30-day mortality in alcoholic hepatitis. MDF >= 32 indicates severe disease where corticosteroids may be beneficial.
How to use & interpret
Maddrey's discriminant function grades the severity of alcohol-related hepatitis from the prothrombin time (compared with control) and serum bilirubin. A value ≥32 defines severe disease with a high short-term mortality.
A DF ≥32 identifies patients who may benefit from corticosteroids (in the absence of contraindications such as active infection or GI bleeding), with response assessed at day 7 (e.g. using the Lille model). Use it alongside MELD, which also prognosticates in this group.
Score interpretation
→ No indication for corticosteroids; alcohol cessation; nutrition; supportive care
→ Consider prednisolone 40mg OD for 28 days (after ruling out infection/GI bleed); use Lille model at day 7 to assess response; pentoxifylline if steroids contraindicated
Interpretation bands for the Maddrey DF. Apply clinical judgement and local guidance.
Frequently asked questions
What does a Maddrey score of 32 or more mean?
It indicates severe alcohol-related hepatitis with high short-term mortality, and is the usual threshold for considering corticosteroid therapy after excluding contraindications.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Prednisolone (Systemic) · Systemic Corticosteroid — Acute Dermatoses
- Prednisolone (Systemic) · Systemic Corticosteroid
- Prednisolone · Glucocorticoid (intermediate-acting)
- Prednisolone (Sudden Sensorineural Hearing Loss) · Corticosteroid (systemic — SSNHL treatment)
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Falls Assessment in Older Adults · NICE CG161 2013
- Anaemia Investigation · BSH / NICE
- Lower Respiratory Tract Infection (Primary Care) · NICE NG138 / NICE antimicrobial guidance
- Hypertension Management · NICE NG136 2019
- Upper GI Bleeding · BSG Guidelines 2019; NICE NG141
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.