Maddrey_Score_guideline v.1

Maddrey's Discriminant Function for Alcoholic Hepatitis

Maryam Razavi

maryam.razavi@cambio.se

To assist clinicians to determine which patients with alcoholic hepatitis have a poor prognosis (short term), patients who could benefit from corticosteroid therapy.

Variables: PT sec PT control sec Total bilirubin umol/l, mg/dl The discriminant function is calculated based on the following formula: DF = 4.6 x (Prothrombin time - Control time) + Bilirubin in mg/dL If bilirubin is provided in μmol/L, the equation can be adapted: DF = 4.6 x (Prothrombin time - Control time) + (Bilirubin in μmol/L)/17.1 Result interpretation: All Maddrey score results above 32 are indicative of a poor prognosis with 35-45% mortality risk within first month. The patient may benefit from corticosteroid therapy and should undergo a liver biopsy. Note: Maddrey's Discriminant Function is useful in predicting short-term prognosis but is less useful for long-term prognosis.

1. Maddrey WC, Boitnott JK, Bedine MS, Weber FL, Mezey E, White RI (1978). Corticosteroid therapy of alcoholic hepatitis. Gastroenterology 75 (2): 193–9. PMID 352788 2. Soultati AS, et. al. Predicting utility of a model for end stage liver disease in alcoholic liver disease. World J Gastroenterol 2006 July 07;12(25):4020-4025

OBSERVATION.lab_test-coagulation_profile.v1, OBSERVATION.maddrey_score.v0, OBSERVATION.lab_test-bilirubin.v1