Modified Maddrey's discriminant function
Maddrey discriminant function (DF) is the traditional model for evaluating the severity and prognosis in alcoholic hepatitis and evaluates the efficacy of using alcoholic hepatitis steroid treatment. The Maddrey DF score is a predictive statistical model compares the subject's DF score with mortality prognosis within 30-day or 90-day scores. The subject's Maddrey DF scored is determined by blood analysis.
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
Reference list
- ^ 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.
- ^ 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. doi:10.1186/1471-230X-2-2. PMC 65516. PMID 11835693.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ 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. doi:10.1053/gast.2000.20189. PMID 11113085.
- ^ 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. doi:10.1136/gut.2010.224097. PMID 20940288.
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