GastroenterologyIntermediate

Maddrey's Discriminant Function & Lille Model (Alcoholic Hepatitis)

Calculates Maddrey Discriminant Function (mDF ≥ 32) to determine steroid eligibility in severe alcohol-associated hepatitis.

Clinical Parameters

5 Variables

Awaiting Clinical Parameters

Configure the patient variables on the left and select Calculate Result to generate the clinical score and stratification.

Verified 2026 GuidelinesInstant Calculation
Jump to Formula & Clinical Protocol ↓
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High Yield Prometric TopicGastroenterology & Hepatology

Tested on Gulf Medical Boards (DHA, SMLE, MOH & HAAD)

Clinical calculations and diagnostic scoring systems like Maddrey's Discriminant Function & Lille Model (Alcoholic Hepatitis) frequently appear on Prometric exams. Master high-yield clinical vignettes with instant AI-powered pathophysiology rationales.

Clinical Significance & Diagnostic Standard
2026 Clinical Reference

What is the Maddrey's Discriminant Function & Lille Model (Alcoholic Hepatitis)?

📋Clinical Summary & Definition Capsule

The Maddrey's Discriminant Function & Lille Model (Alcoholic Hepatitis) is an evidence-based clinical decision rule engineered to quantify diagnostic probability, stratify clinical severity, and guide therapeutic decision-making in gastroenterology & hepatology practice. Implements the Maddrey Discriminant Function (mDF) and Lille Model response evaluation to identify severe alcohol-associated hepatitis, predict 30-day mortality (~35-50%), and guide 28-day oral prednisolone therapy vs early discontinuation. Clinical scoring tools like Maddrey's Discriminant Function & Lille Model (Alcoholic Hepatitis) are essential in acute and outpatient management, enabling clinicians to objectively differentiate between low-risk candidates suitable for conservative therapy and high-risk patients requiring urgent interventions. Verified against current 2026 clinical standards, this tool is extensively tested on Gulf health authority licensing exams including DHA (Dubai), SMLE (Saudi Arabia), MOH, HAAD/DOH (Abu Dhabi), OMSB (Oman), and QCHP (Qatar).

💡Clinical Pearls & Diagnostic Utility

Pivotal clinical decision rule that identifies patients with life-threatening alcoholic hepatitis who derive clear survival benefit from corticosteroid therapy.

Mathematical Formulation

Formula & Calculation Parameters

The mathematical equation and clinical variables required to calculate Maddrey's Discriminant Function & Lille Model (Alcoholic Hepatitis):

mDF = 4.6 × [Patient PT (sec) - Control PT (sec)] + Total Bilirubin (mg/dL)
mDF ≥ 32 defines severe alcoholic hepatitis with ~35–50% 30-day mortality.
Risk Stratification

Score Interpretation & Clinical Stratification

Score RangeClinical InterpretationRisk Tier
≤ 31.9Mild-to-Moderate Alcoholic Hepatitis (mDF < 32 / Low 30-Day Mortality)green
32 – 54Severe Alcoholic Hepatitis (mDF 32 - 54 / Corticosteroids Indicated)yellow
≥ 54.1Very Severe Alcoholic Hepatitis (mDF > 54 / High 30-Day Mortality ~50%)red
Clinical Limitations & Contraindications

When to Exercise Caution

Laboratory PT variation between reagents requires using exact control PT from the same testing laboratory.

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Medical Review & Guidelines Compliance
MD

Clinical Review Board

Dr. Muhammad Nouman, MBBS

Capital Medical University | PMDC Reg No: 117744-P

Clinical Audit Status

✓ Verified for 2026 Guidelines

Last updated: 2026-08-08

Peer-Reviewed Medical Literature

  • Maddrey WC, et al. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978;75(2):193-199.
  • Louvet A, et al. The Lille model: a new tool for early identification of patients with severe alcoholic hepatitis not responding to corticosteroids. Hepatology. 2007;45(6):1348-1354.
  • Singal AK, et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol. 2024;119(1):30-54.
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