Maddrey Discriminant Function
The Maddrey Discriminant Function is a calculation for patients with alcoholic hepatitis and stratifies them for risk of mortality and the use of steroids.
4.6 * (
PT – Control
PT ) +
Tbili )
Explanation of Result : If > 32 indicates a poor prognosis and potential for steroid use. * Please verify all calculations prior to clinical use.
References
- Maddrey WC, Boitnott JK, Bedine MS, Weber FL Jr, Mezey E, White RI Jr. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978 Aug;75(2):193-9. PMID: 352788.
Fifty-five patients with alcoholic hepatitis were studied in a 28- to 32-day randomized double blind treatment trial comparing prednisolone (40 mg per day) with placebo therapy. Of 31 placebo-treated patients, 4 died during the study interval and 2 more died within 5 days of study completion. Only 1 of 24 prednisolone-treated patients died during the same interval (Fisher exact test; P = 0.10). Stepwise discriminant analysis of laboratory factors associated with death revealed independently significant associations with prolongation of prothrombin time and height of serum bilirubin at the initiation of the study. When treatment was included as a variable in this discriminant analysis, it was found that corticosteroid therapy significantly d [...]
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