Units: Conventional Standard

Maddrey’s modified Discriminant Function (mDF)

Pt's Prothrombin Time (PT) sec
Lab Control Prothrombin Time (PT) sec
Pt's Serum Total Bilirubin μmol/L
Discriminant Function points  

≥32 points indicates poor prognosis and patient may benefit from glucocorticoid therapy.

American College of Gastroenterology defines severity of alcoholic hepatitis as a modified Discriminant Function (mDF) ≥ 32 and/or hepatic encephalopathy. This is calculated as mDF = 4.6 (PTpatient–PTcontrol)+ serum bilirubin (µmol/l)/17.1

This is based on recent studies where a mDF ≥ 32 and/or hepatic encephalopathy was associated with a 65% 28-day survival in placebo treated patients. While those with a score less than 32 had a survival of 93%.American College of Gastroenterology recommends prednisolone should be used in patients with severe alcoholic hepatitis ( where mDF ≥ 32) in whom the diagnosis is certain.

Disclaimer:
The calculators allow you to enter patient specific information to calculate a simple score. All information is provided for educational purposes only. This information is not intended to replace clinical judgement. All calculations must be rechecked and should not be used alone to guide patient care. The user assumes sole responsibility for any decisions or action taken based on the information contained here.