Modified Maddrey's discriminant function

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The modified Maddrey's discriminant function) was originally described by Maddrey and Boitnott[1] to predict prognosis in alcoholic hepatitis. It is calculated by a simple formula:

(4.6 x (PT test - control))+ S.Bilirubin in mg/dl

Prospective studies have shown that it is useful in predicting short term prognosis especially mortality within 30 days.[2] A value more than 32 implies poor outcome with one month mortality ranging between 35% to 45%.[3] Corticosteroid therapy or pentoxifylline have been used with mixed results for patients whose increased mortality is indicated with a value greater than 32. [4]

To calculate Maddrey discriminant function using SI units - micromol/l (i.e. not US) divide bilirubin value by 17.

See also[edit]

Reference list[edit]

  1. ^ Maddrey WC, Boitnott JK, Bedine MS, Weber FL, Mezey E, White RI (1978). "Corticosteroid therapy of alcoholic hepatitis". Gastroenterology. 75 (2): 193–9. PMID 352788. 
  2. ^ Sheth M, Riggs M, Patel T (2002). "Utility of the Mayo End-Stage Liver Disease (MELD) score in assessing prognosis of patients with alcoholic hepatitis". BMC gastroenterology. 2: 2. PMC 65516Freely accessible. PMID 11835693. doi:10.1186/1471-230X-2-2. 
  3. ^ Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O (2000). "Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial". Gastroenterology. 119 (6): 1637–48. PMID 11113085. doi:10.1053/gast.2000.20189. 
  4. ^ Mathurin P, O'Grady J, Carithers RL, Phillips M, Louvet A, Mendenhall CL, Ramond MJ, Naveau S, Maddrey WC, Morgan TR (2011). "Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis: meta-analysis of individual patient data.". Gut. 60 (2): 255–60. PMID 20940288. doi:10.1136/gut.2010.224097.