What does a Maddrey DF score of 32 or above mean?

A DF ≥ 32 defines severe alcoholic hepatitis. Studies show a 1-month mortality of roughly 35–45% without treatment. These patients are typically evaluated for corticosteroid therapy (prednisolone 40 mg/day) in the absence of contraindications such as active infection or GI bleeding.

What bilirubin unit does this calculator use?

Serum bilirubin should be entered in mg/dL, which is the unit used in the original Maddrey formula. If your result is in µmol/L, divide by 17.1 to convert to mg/dL.

What is the control PT?

The control PT is the lab's normal reference prothrombin time — usually 11–13 seconds depending on the reagent used. Subtract the control PT from the patient's PT to get the PT prolongation.

Is the Maddrey DF the only scoring tool for alcoholic hepatitis?

No. The MELD score, Glasgow Alcoholic Hepatitis Score (GAHS), and ABIC score are also used. The Maddrey DF remains widely validated and is specifically cited in most steroid-therapy trial criteria.

Does this tool provide medical advice?

No. This calculator is for educational and clinical decision-support purposes only. Always apply clinical judgment and consult current guidelines before making treatment decisions.

Maddrey Discriminant Function

Name: Maddrey Discriminant Function
Availability: InStock
Author: Nham Vu

Calculate the Maddrey Discriminant Function score to assess alcoholic hepatitis severity — a DF ≥ 32 indicates severe disease and potential candidacy for corticosteroid therapy.

Lab Values

Patient PT (seconds)

Control PT (seconds, lab reference)

Typically 11–13 s; use your lab's reference.

Serum Total Bilirubin (mg/dL)

If in µmol/L, divide by 17.1 first.

Formula

DF = 4.6 × (Patient PT − Control PT) + Serum Bilirubin (mg/dL)

Reference: Maddrey WC et al. Gastroenterology 1978;75(2):193–199. DF ≥ 32 = severe disease; DF < 32 = non-severe.

Summary

Calculate the Maddrey Discriminant Function score to assess alcoholic hepatitis severity — a DF ≥ 32 indicates severe disease and potential candidacy for corticosteroid therapy.

How it works

Enter the patient's prothrombin time (PT) in seconds.
Enter the control PT (the lab's reference PT, typically 11–13 s).
Enter the serum bilirubin level in mg/dL.
The calculator computes DF = 4.6 × (patient PT − control PT) + serum bilirubin.
A DF ≥ 32 suggests severe alcoholic hepatitis; review steroid candidacy.

Use cases

Assess severity in a patient with known alcoholic hepatitis.
Determine whether to consider corticosteroid (prednisolone) therapy.
Screen patients who may benefit from pentoxifylline as an alternative.
Communicate prognosis to the care team at admission.
Track disease progression across serial lab draws.
Triage ICU vs. general ward placement for hepatology patients.

Frequently Asked Questions

Last updated: 2026-07-23 · Reviewed by Nham Vu