Maddrey's Discriminant Function Calculator
Calculate Maddrey's Discriminant Function to grade severity of alcoholic hepatitis and assess potential need for corticosteroid therapy.
What is Maddrey's Discriminant Function?
Maddrey's Discriminant Function (DF), introduced by Maddrey et al. in 1978, was the first prognostic index for severe alcoholic hepatitis. A DF of 32 or higher identifies patients with high short-term mortality who may benefit from corticosteroid therapy. The Lille score is then used at day 7 to decide whether to continue or stop steroids based on bilirubin response.
How is it calculated?
DF = 4.6 × (patient prothrombin time − control PT in seconds) + serum bilirubin (mg/dL). DF ≥ 32 traditionally defines severe alcoholic hepatitis warranting consideration of pharmacologic therapy.
Frequently Asked Questions
- Does DF replace MELD?
- No — many centres now use MELD ≥ 21 alongside or instead of DF.
- Why use control PT?
- It accounts for the laboratory's specific reagents.
- Can DF be re-checked?
- Yes — but the Lille score is the standard mid-treatment assessment.
- Is corticosteroid therapy always given when DF ≥ 32?
- No — sepsis and active GI bleeding are common contraindications.