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Maddrey discriminant function

Estimates alcoholic hepatitis severity from prothrombin time and bilirubin. Values ≥ 32 identify patients with high short-term mortality who are corticosteroid candidates.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

Modified Maddrey/Carithers 1989: 4.6×(patient PT−control PT)+bilirubin; excludes original 1978 absolute-PT equation

The original 1978 function was studied in alcoholic hepatitis. The local modified form, with a prothrombin-time difference and cutoff of 32, must correspond to the later 1989 edition. The total does not replace assessment of contraindications, infection and alternative diagnoses before any therapeutic decision.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Patient prothrombin time · s
Control prothrombin time · s
Total bilirubin · mg/dL

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

DF = 4.6 × (patient PT − control PT, in seconds) + total bilirubin (mg/dL).

References

Identifier: funcao-discriminante-de-maddrey

Original clinical content: Brazilian Portuguese.

Method version

Modified Maddrey/Carithers 1989: 4.6×(patient PT−control PT)+bilirubin; excludes original 1978 absolute-PT equation

funcao-discriminante-de-maddrey@native-2026-10-03+7eda95d4925b

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Patient prothrombin time: 15 s
Control prothrombin time: 12 s
Total bilirubin: 5 mg/dL

{
  "tp": 15,
  "tpc": 12,
  "bili": 5
}

Expected result

{
  "df": 18.8
}

Actual result

{
  "df": 18.8
}

Case 2

reference-002

Inputs

Patient prothrombin time: 17 s
Control prothrombin time: 12 s
Total bilirubin: 9 mg/dL

{
  "tp": 17,
  "tpc": 12,
  "bili": 9
}

Expected result

{
  "df": 32
}

Actual result

{
  "df": 32
}

Case 3

reference-003

Inputs

Patient prothrombin time: 25 s
Control prothrombin time: 12 s
Total bilirubin: 10 mg/dL

{
  "tp": 25,
  "tpc": 12,
  "bili": 10
}

Expected result

{
  "df": 69.8
}

Actual result

{
  "df": 69.8
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.