How is Maddrey DF calculated?

mDF = 4.6 x (patient PT minus control PT in seconds) + total bilirubin in mg/dL. Score >= 32 defines severe alcoholic hepatitis with 30-day mortality > 30% without treatment.

What treatment is indicated when mDF >= 32?

Prednisolone 40 mg/day for 28 days (or methylprednisolone 32 mg/day IV) is recommended for mDF >= 32 in the absence of contraindications (active infection, GI bleeding, renal failure). Reduces 30-day mortality.

What are contraindications to steroids in alcoholic hepatitis?

Active infection (uncontrolled), GI bleeding, renal failure (Cr > 2.5 mg/dL), hepatitis B co-infection without antiviral prophylaxis. Lille score assessed at Day 7 to determine if steroids should be continued.

Maddrey Discriminant Function for Alcoholic Hepatitis

Calculate Maddrey Discriminant Function (mDF) for alcoholic hepatitis severity. mDF = 4.6 x (PT minus control PT) + serum bilirubin (mg/dL). Score > 32 indicates severe disease warranting corticosteroid therapy.

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Frequently Asked Questions

How is Maddrey DF calculated?

What treatment is indicated when mDF >= 32?

What are contraindications to steroids in alcoholic hepatitis?