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mDF Calculator (modified Discriminant Function)

Maddrey’s Discriminant Function
A calculator to predict the severity and short-term prognosis of Alcoholic hepatitis patients.
mDF = 4.6 x (PT[patient](s) – PT[control](s)) + Total bilirubin (mg/dL)








mDF < 32 : Moderate alcoholic hepatitis
mDF ≥ 32 : Severe alcoholic hepatitis

Reference :
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.

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EASL Clinical Practice Guidelines: Management of alcohol-related liver disease (2018)
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In patients with a clinical diagnosis of alcoholic hepatitis, confounding factors (see text) need to be ruled out, if necessary, by transjugular (TJ) liver biopsy. Patients with severe alcoholic hepatitis (AH), defined as Maddrey discriminant function (MDF) ≥32 or Model for End-Stage Liver Disease (MELD) score >20, without contraindications for glucocorticoids (see text) are candidates for such treatment. Nonresponders or patients with contraindications for treatment should be considered for early liver transplantation (LT) or supportive or palliative care, as clinically appropriate. (Harrison’s Principles of Internal Medicine 21st Edition)
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EASL Clinical Practice Guidelines: Management of alcohol-related liver disease (2018)

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