GastroenterologyBeginner

Maddrey's Discriminant Function

Assesses severity of alcoholic hepatitis and indication for steroids.

Clinical Parameters

3 Variables
seconds
seconds
mg/dL

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 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?

📋Clinical Summary & Definition Capsule

The Maddrey's Discriminant Function is an evidence-based clinical decision rule engineered to quantify diagnostic probability, stratify clinical severity, and guide therapeutic decision-making in gastroenterology & hepatology practice. Maddrey's Discriminant Function (mDF) is used to predict the short-term prognosis of patients with alcoholic hepatitis and to identify those who may benefit from corticosteroid therapy. Clinical scoring tools like Maddrey's Discriminant Function 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

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

Mathematical Formulation

Formula & Calculation Parameters

The mathematical equation and clinical variables required to calculate Maddrey's Discriminant Function:

mDF = 4.6 × (Patient PT - Control PT) + Total Bilirubin (mg/dL)
Risk Stratification

Score Interpretation & Clinical Stratification

Score RangeClinical InterpretationRisk Tier
≤ 31Mild/Moderategreen
≥ 32Severe (Consider Steroids)red
Clinical Limitations & Contraindications

When to Exercise Caution

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.

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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: 2026-08-07

Peer-Reviewed Medical Literature

  • Maddrey WC, Boitnott JK, Bedine MS, et al. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978;75(2):193-199.
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