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Maddrey Discriminant Function Calculator
Calculate the Maddrey Discriminant Function (MDF) for alcoholic-hepatitis severity context and compare it with related liver-severity markers such as MELD.
⚠️ Medical Disclaimer: This page is an educational liver-severity worksheet for suspected alcoholic hepatitis. It is not a treatment pathway, triage tool, or transplant-eligibility assessment.
seconds
seconds
mg/dL
mg/dL
g/dL
years
Maddrey Discriminant Function⧉
44.8
MDF in the severe range (≥ 32)
Severity⧉
Severe (MDF ≥ 32)
This score is above the classic severe-range cutoff reported in the MDF literature. Read it with MELD and the rest of the clinical picture rather than as a stand-alone directive.
Historical 28-Day Mortality Context⧉
~35-50% in older cohorts
Older cohort-based context, not an individual prognosis
MELD Score⧉
25
MELD ≥21 adds more severe liver-dysfunction context
Interpretation Context⧉
Above the classic severe-range cutoff
MDF is a severity marker, not a stand-alone management tool
Lille Score Context⧉
A full Lille score requires a day-7 bilirubin value and is not calculated on this page
A full Lille score needs day-7 bilirubin and is not computed here
MDF Calculation Breakdown
| Component | Value | Contribution |
|---|---|---|
| Patient PT − Control PT | 8.0 sec | × 4.6 = 36.8 |
| Total Bilirubin | 8 mg/dL | + 8 |
| Total MDF | 44.8 | |
How This Score Is Usually Contextualized
| Step | Context Check | Details |
|---|---|---|
| 1 | Calculate MDF | See whether the result falls below or above the classic severe-range threshold |
| 2 | Compare with MELD | Use another liver-severity summary rather than relying on one score alone |
| 3 | Note the broader picture | Renal function, encephalopathy, infection, bleeding, and nutrition still matter |
| 4 | Understand Lille timing | Lille is a day-7 response score and cannot be computed from baseline data alone |
| 5 | Review trends | Bilirubin, INR, creatinine, and clinical change over time add context |
| 6 | Keep the limits in mind | No single score captures the full prognosis or treatment pathway |
Comparison of Severity Scores
| Score | Threshold | Common Reference Point | This Patient |
|---|---|---|---|
| MDF | ≥ 32 | Classic severe-range cutoff in alcoholic-hepatitis literature | 44.8 |
| MELD | ≥ 21 | Additional liver-severity context often reviewed beside MDF | 25 |
| GAHS | ≥ 9 | Another published severe-range reference point | 8 |
Planning notes, formulas, and examples
About the Maddrey Discriminant Function Calculator
The Maddrey Discriminant Function (MDF) is a long-used bedside severity score for suspected alcoholic hepatitis. It combines prothrombin-time prolongation and total bilirubin into a single number that helps place a case below or above the classic severe-range threshold described in the literature.
This page is best used as an educational severity worksheet, not as a management pathway. MDF is usually interpreted alongside MELD, encephalopathy, renal function, infection status, and laboratory trends rather than on its own. The calculator keeps those related markers together so the score can be read in broader liver-injury context.
When This Page Helps
The discriminant function is useful when you want to place PT prolongation and bilirubin into a familiar severe-versus-non-severe framework. This page keeps MDF, MELD, and Lille timing context together so the result stays anchored to the rest of the severity picture.
How to Use the Inputs
- Enter the patient's prothrombin time (PT) in seconds.
- Enter the laboratory's control PT value.
- Enter total bilirubin, creatinine, albumin, and INR.
- Enter the patient's age and hepatic encephalopathy status.
- Review the MDF score, MELD context, and severe-range framing.
- Remember that a full Lille score needs day-7 bilirubin and is not calculated here.
Formula used
Maddrey Discriminant Function (MDF):
MDF = 4.6 × (Patient PT − Control PT) + Total Bilirubin (mg/dL)
Threshold: MDF ≥ 32 = Classic severe-range cutoff in alcoholic-hepatitis literature
MELD = 3.78 × ln(Bilirubin) + 11.2 × ln(INR) + 9.57 × ln(Creatinine) + 6.43
Lille Score (day 7): Uses day-0 and day-7 bilirubin, age, albumin, creatinine, and PT. It is mainly a follow-up response score and is not fully calculated on this page.Example Calculation
Result: MDF = 4.6 × (22−12) + 12 = 58.0 — Above the classic severe-range cutoff
MDF 58.0 exceeds the ≥32 threshold, placing the case in the severe range described in the original MDF framework. It should still be interpreted with MELD, renal function, encephalopathy, and the rest of the liver-injury picture rather than as a stand-alone conclusion.
Tips & Best Practices
- Always use the laboratory's control PT (typically 11–13.5 seconds), not a reference value from another lab.
- MDF and MELD both describe severity, and discordance between them is a reason to step back and review the broader case carefully.
- Infection, GI bleeding, renal failure, encephalopathy, and nutrition still matter even when the MDF is high.
- Lille is a day-7 response tool; this page does not calculate it directly from day-7 bilirubin.
- The score is most useful when it is reviewed with specialist input rather than in isolation.
- Use local clinical references if you need management guidance; this page is only an educational severity summary.
What MDF Measures
Alcoholic hepatitis can involve jaundice, impaired hepatic synthetic function, renal dysfunction, encephalopathy, and other complications. MDF focuses on only two pieces of that picture: bilirubin and prothrombin-time prolongation. That narrow scope is useful for a quick severity summary, but it also explains why MDF can never describe the whole case by itself.
Why MDF Is Still Used
MDF remains one of the quickest ways to summarize bilirubin elevation and coagulopathy in a single number. Even though other scores such as MELD are also widely used, MDF still gives a familiar severe-versus-non-severe anchor for educational discussion and historical comparison.
Limits of the Worksheet
This page keeps MELD and Lille timing context visible so the MDF result is not read in isolation. Even so, it is still only a simplified worksheet. Real interpretation depends on trends over time, complications, and direct clinical assessment rather than on one score alone.
Sources & Methodology
Last updated:
Methodology
This worksheet applies the classic Maddrey discriminant function and related liver-risk comparisons to summarize alcoholic hepatitis severity context. It is a comparison aid, not a treatment order or diagnosis on its own.
Sources
- Maddrey discriminant function (Maddrey et al.) — Original alcoholic hepatitis prognostic equation.
- Alcoholic hepatitis guidance (AASLD) — Clinical context for liver-disease severity interpretation.
Frequently Asked Questions
The MDF is a bedside severity score developed in 1978 for suspected alcoholic hepatitis. It weights prothrombin-time prolongation and bilirubin into a single number that helps separate lower-severity presentations from the severe range commonly discussed in hepatology practice.
MDF ≥ 32 is the classic cutoff used to flag the severe range in alcoholic-hepatitis literature. It is a severity marker, not a stand-alone pathway, so the result still needs broader clinical interpretation.
The Lille score is a day-7 follow-up score that uses the bilirubin trend along with age, albumin, creatinine, and PT. Because it depends on day-7 data, this page only notes its role and does not calculate it fully.
MDF and MELD describe overlapping but different parts of the same liver-injury picture. Reviewing both helps frame whether a result looks consistently severe or whether other context needs closer review.
No. This page is an educational severity worksheet. It does not determine medication use, ICU care, transplant eligibility, or any other treatment decision.
The short-term mortality context comes from older cohorts and broad severity categories. It should be read as background information rather than as an individualized prediction.
No. MDF is only one score. Alcoholic-hepatitis assessment still depends on the broader clinical picture, laboratory trends, complications, and direct clinical review.
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