Clinical Overview
Maddrey's Discriminant Function (mDF) is an essential tool in hepatology. It evaluates the severity of alcoholic hepatitis, a life-threatening condition characterized by profound jaundice and coagulopathy.
Pathophysiology & Evidence
Alcoholic hepatitis causes severe hepatocellular necrosis. The liver's synthetic function collapses, marked by a prolonged Prothrombin Time (PT) due to the failure to synthesize vitamin K-dependent clotting factors. Simultaneously, impaired excretion causes bilirubin to skyrocket.
Formula Breakdown
mDF = 4.6 * (Patient PT - Control PT) + Serum Bilirubin
A score ≥ 32 indicates a 1-month mortality risk exceeding 30% if untreated. These patients are generally considered candidates for a 28-day course of corticosteroids (e.g., prednisolone), provided there are no contraindications such as active gastrointestinal bleeding or sepsis.