Modified Maddrey's discriminant function

The modified Maddrey's discriminant function) was originally described by Maddrey and Boitnott^[1] to predict prognosis in alcoholic hepatitis. It is calculated by a simple formula:

${4}.{6}\times\ \left [ prothombin\ time\ -\ control\ value\ (seconds)\right ]\ +\ serum\ bilirubin\ (mg/dl)\,$

Prospective studies have shown that, it is useful in predicting short term prognosis especially mortality within 30 days.^[2] A value more than 32 implies poor outcome with one month mortality ranging between 35% to 45%.^[3]

To calculate Maddrey discriminant function using SI units - micromol/l (i.e. not US) divide bilirubin value by 17.

See also

• Model for End-Stage Liver Disease
• Child-Pugh score

Reference list

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. ^ Sheth M, Riggs M, Patel T (2002). "Utility of the Mayo End-Stage Liver Disease (MELD) score in assessing prognosis of patients with alcoholic hepatitis". BMC gastroenterology 2: 2. doi:10.1186/1471-230X-2-2. PMID 11835693. 
3. ^ Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O (2000). "Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial". Gastroenterology 119 (6): 1637–48. doi:10.1053/gast.2000.20189. PMID 11113085.