Severe cases are definitely an indication for corticosteroids that are demonstrated to improve short term survival in the patients.Įxcessive alcoholism leads to several hepatic symptoms and affect the liver function to different degrees. Alcoholic hepatitis and cirrhosisĪlcoholic cirrhosis patients also have superimposed alcoholic hepatitis compensated or not and usually score high in most severity indexes, even in the model of end stage liver disease. The only criticism given to the model relates to the usage of the variables for mortality risk stratification but being able to account for in time progression thus cannot really be used for proper monitoring. To begin with, the discriminant function was used just to predict prognosis and mortality within 30 days and following studies also attributed value in the management of the hepatitis as well, as an indicator for the clinician to start or not corticosteroid therapy. In the generic guidelines of the Maddrey score, results above 32 are suggestive for a poor prognosis with 35-45% mortality risk within first month and demand a liver biopsy while they indicate potential need for corticosteroid therapy as a treatment in patients with severe acute alcohol related hepatitis. Once all data is filled in, the calculator will provide the result as a numeric score which is further on to be interpreted by the clinician. ■ DF = 4.6 x (prothrombin time - control time) + (bilirubin in μmol/L)/17.1 ■ DF = 4.6 x (prothrombin time - control time) + bilirubin in mg/dL The two formulas adapted for the measurements units are: For convenience, the user can choose the measurement system either SI or US therefore can input serum bilirubin in either mg/dL or μmol/L ■ Bilirubin – reflecting the metabolic function of the liver, usually elevated in cases of alcoholic liver disease. ■ Control time measured in seconds – differs based on each medical laboratory specifications and is usually between 10 and 14 seconds. Normal range is between 11 to 13.5 seconds in patients that are not under blood thinning medication such as warfarin. Also often given as the INR (international normalized ratio) result directly. ■ Prothrombin time measured in seconds – indicative of the liver function as reflected in how long it takes for blood (plasma to be exact) to clot. The three factors used by the Maddrey score for alcoholic hepatitis calculator that are used in risk stratification are explained below: This is a health tool also known as the Maddrey’s discriminant function (DF) that predicts the outcome, mortality risk in one month, in patients suffering from alcohol-related hepatitis and also identifies cases in which steroid therapy is recommended. How does this Maddrey score for alcoholic hepatitis calculator work?
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