Maddrey Discriminant Function (Alcoholic Hepatitis) — free guideline decision tool

Grade alcoholic hepatitis severity with the Maddrey discriminant function (DF).

DF = 4.6 × (patient PT − control PT) + total bilirubin (mg/dL). DF ≥ 32 = severe. Calculate DF = 4.6 × (patient PT − control PT) + total bilirubin (mg/dL); use the same units consistently when converting from INR-based workflows.

Decide on corticosteroid therapy in alcoholic hepatitis.

DF ≥32 defines severe alcoholic hepatitis historically considered for corticosteroids; reassess steroid response with the Lille score and consider concurrent MELD.

DF ≥ 32 indicates severe disease with high short-term mortality. The classic threshold for considering corticosteroids. Reassess steroid response with the Lille score; MELD also used.

PT/control lab methods vary — local assay calibration affects the DF. Infection, GI bleed, and renal failure can contraindicate or delay steroids even when DF ≥32. MELD and Lille often refine decisions beyond a single Maddrey threshold. For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

Inputs: Patient prothrombin time 20 s, Control PT 12 s, Total bilirubin 8 mg/dL → Result: Maddrey DF 44.8（Interpretation: ≥ 32: severe alcoholic hepatitis — consider corticosteroids (if no contraindication) and assess MELD/Lille., Formula: 4.6 × (PT − control PT) + bilirubin (mg/dL)）