AI Summary The Maddrey discriminant function (MDF) combines prothrombin time and bilirubin from blood tests into one score that rates how severe alcohol-associated hepatitis is. A score of 32 or higher usually means severe disease, and doctors may then consider steroids if there is no contraindication, such as uncontrolled infection or bleeding. MDF does not diagnose the condition. The Lille score checks steroid response at about day 7. Stopping alcohol and good nutrition are essential for recovery.
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The Maddrey discriminant function (MDF) is a score that combines two blood test results, prothrombin time and bilirubin, into one number. Doctors use it in alcohol-associated hepatitis, a sudden, serious inflammation of the liver linked to heavy alcohol use.
The number helps your care team judge how severe the illness is and whether steroid treatment is an option. It is one tool among several. Your doctor reads it alongside your symptoms, other scores, and other test results.
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ALCOHOLIC HEPATITIS SEVERITY SCORE
The Maddrey discriminant function (Maddrey DF, or MDF) is a clinical score. It combines your prothrombin time (how long your blood takes to clot) and your bilirubin level (a yellow pigment that builds up when the liver is not working well). Together they give one number that reflects how severe your illness is.
Doctors use MDF to rate alcohol-associated hepatitis (AH). In AH, the liver becomes inflamed and injured after heavy drinking. Some people with AH have severe liver dysfunction even without cirrhosis, which is permanent scarring.
An MDF is not a scan, a biopsy, or a separate test you book. Your care team works it out from blood results you already have. It also does not diagnose AH. Doctors usually make that diagnosis from your alcohol history, symptoms, and lab results.
You may also see the score written as mDF or "Maddrey score." They all point to the same tool.
ALCOHOLIC HEPATITIS ASSESSMENT
MDF is used in one main situation: a person who seems to have alcohol-associated hepatitis and needs a severity rating.
Doctors suspect AH when a person has recent heavy alcohol use, jaundice (yellowing of the skin and eyes) that started recently, and a high bilirubin level. Liver enzymes called aminotransferases are usually moderately raised, under 400 IU/L, and the AST/ALT ratio is above 1.5. Doctors usually diagnose AH from this picture, so a liver biopsy is not routinely needed.
MDF and the MELD score are the main tools for rating severity in AH. Both help pick out people at high risk of dying in the short term, so the care team can plan treatment.
Corticosteroids are recommended for severe AH, typically defined as an MDF of 32 or higher or a high MELD score, if no contraindication is present. Steroids are not advised with uncontrolled infection or bleeding in the digestive tract.
MDF CALCULATION INPUTS
MDF needs only two blood results. Your lab or care team calculates the score for you.
PT measures how long your blood takes to clot. The liver makes the proteins that help blood clot, so a longer time can point to changes in liver function. A typical result is 9.4 to 12.5 seconds. Vitamin K status and other conditions can also lengthen PT. Some labs report the same information as INR (international normalized ratio).
Bilirubin is a yellow pigment made when old red blood cells break down. A healthy liver clears it. When the liver is damaged, bilirubin builds up in the blood and can cause jaundice. A typical result is 0.1 to 1.2 mg/dL.
MDF does not include kidney function, sodium, or your symptoms. The MELD score adds kidney function (creatinine) to bilirubin and INR. This is one reason doctors often look at more than one score.
MDF SCORE OF 32 EXPLAINED
The usual cutoff is 32. Your doctor decides what the number means for you.
Your MDF is one number taken at one moment. Your care team weighs it with your exam, other scores, infection risk, and other health conditions.
MDF VS MELD VS LILLE
Doctors rarely rely on one number. These three scores answer different questions in alcohol-associated hepatitis.
| Score | What it uses | What it helps answer |
|---|---|---|
| Maddrey discriminant function (MDF) | Prothrombin time and bilirubin | How severe is the hepatitis, and are steroids an option? A score of 32 or higher is typically severe. |
| MELD score | Bilirubin, INR, and creatinine (sometimes sodium) | How high is the short-term risk? It is also used to prioritize people for liver transplant. |
| Lille score | Checked after about 7 days of steroids | Is the treatment working? A score of 0.45 or higher means a non-responder, and steroids should be stopped. |
Your care team decides which scores fit your situation.
MDF NEXT STEPS
What happens next depends on your score, your other results, and your overall health.
Ask your care team to explain your score in plain words, and to tell you when it will be checked again.
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Common Questions
A Maddrey DF of 32 or higher typically defines severe alcohol-associated hepatitis. Higher scores have been linked to a higher risk of dying in the short term, which is why 32 became the usual cutoff. A score at or above 32 does not decide your treatment alone. Your doctor may then consider steroids if you have no contraindication, such as uncontrolled infection or bleeding in the digestive tract. Your doctor also weighs your MELD score, symptoms, and infection risk.
MDF does not have a "normal" range the way a blood test does. It is made for people who already have suspected alcohol-associated hepatitis, so it is not a screening number for healthy people. The usual cutoff is 32. A score below 32 is usually not labeled severe, and steroids are not helpful in mild disease. Even so, your doctor may keep watching you closely and may use the MELD score or your symptoms to judge severity.
No. MDF rates how severe the illness is. It does not confirm the diagnosis. Doctors diagnose alcohol-associated hepatitis mainly from your alcohol history, recent jaundice, and lab results, such as a high bilirubin level and a raised AST/ALT ratio. A liver biopsy is not routinely needed. Once the diagnosis is made, MDF helps your care team judge how serious it is.
No. They are two different scores, though both help rate severity in alcohol-associated hepatitis. MDF uses prothrombin time and bilirubin only. MELD uses bilirubin, INR, and creatinine, and sometimes sodium, so it also reflects kidney function. MELD is also used to prioritize people for liver transplant. Both scores are used to rate severity, and each can support a steroid decision. Doctors often look at both.
Not always. A high MDF means steroids may be an option, but your doctor makes the final choice. Steroids aim to lower the short-term risk of dying by calming liver inflammation. They do not reverse cirrhosis. They are not advised with uncontrolled infection or bleeding in the digestive tract. They can also raise the risk of infection, bleeding, and metabolic problems, such as higher blood sugar, so doctors choose patients carefully. If you start steroids, your team checks your response with the Lille score at about day 7.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.
