Maddrey Discriminant Function (Maddrey DF)

Alcoholic hepatitis is a severe, life-threatening form of alcohol-related liver disease. The Maddrey DF was the first tool to accurately identify patients at high risk of short-term mortality, defined as those who should be considered for treatment with prednisolone.

A score of 32 or higher indicates "severe" disease, associated with a 30-day mortality rate of 30-50% without medical intervention. Patients with a score < 32 are considered "non-severe" and generally have an excellent short-term prognosis with supportive care alone.

Despite the development of newer scores like MELD and ABIC, the Maddrey DF remains the entry criterion for most clinical trials and is explicitly recommended by AASLD and EASL guidelines for initiating steroids.