Calculator

Patient PT (seconds)

Control PT (seconds, lab ISI batch)

Total bilirubin (mg/dL)

Use the same PT assay and control as your laboratory reports; many sites now also use MELD-based criteria for trials and care pathways.

Maddrey discriminant function

How it works

What this tool does

It reproduces the Maddrey discriminant function used historically to stratify severity in alcoholic hepatitis and to contextualize corticosteroid trials.

Formula

DF = 4.6 × (PT_patient − PT_control) + bilirubin (mg/dL)

Teaching cutoff

A DF of 32 or greater has been widely taught as “severe” disease in older literature; modern care uses additional scores (e.g., MELD, Lille response) and multidisciplinary decisions.

References

Maddrey WC, Boitnott JK, Bedine MS, Weber FL Jr, Mezey E, White RI Jr. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978;75(2):193-199.

Dosing & care

Limitations

Does not incorporate INR-based variants, infection, GI bleeding, or drug-induced liver injury mimics; not a substitute for specialist care.

Care pathways (teaching)

Severe alcoholic hepatitis management is guideline- and center-specific; involve hepatology early for corticosteroid eligibility, infection screening, and bleeding risk.
Modern pathways often integrate MELD, Lille response at day 7, nutrition, alcohol cessation support, and ICU-level monitoring—not DF alone.
Do not start or stop systemic steroids based solely on this calculator; decisions require full clinical context and local protocols.

Educational tool only—not for diagnosis or treatment decisions.