Treatment of Alcoholic Hepatitis with Maddrey Discriminant Function ≥32 or MELD Score >20

Severe alcoholic hepatitis carries substantial short-term mortality risk. Two scoring thresholds — Maddrey Discriminant Function (MDF) ≥32 and MELD score >20 — identify patients who require prompt, targeted intervention. This protocol applies to patients meeting either threshold who have no contraindications to corticosteroids.

A Maddrey Discriminant Function of 32 or higher should be used to assess the need for treatment, and a MELD score greater than 20 similarly prompts consideration of active therapy. Both thresholds mark the boundary at which the severity of liver injury warrants structured medical management. Patients must be evaluated for contraindications before proceeding.

For carefully selected patients with a favourable psychosocial profile, a surgical intervention targeting the underlying liver failure may be considered as part of the management pathway. Full eligibility criteria, the complete therapeutic algorithm, and all associated clinical steps are available in the structured protocol.

Complete regimen and decision algorithm available via the link below →