The "Meddry Score" Does Not Exist in Medical Literature
You are likely referring to the "Maddrey Discriminant Function" (MDF), also called the "Maddrey score," which is a critical prognostic tool specifically for assessing severity in acute alcoholic hepatitis, not general liver disease.
What is the Maddrey Score?
The Maddrey Discriminant Function is used exclusively to evaluate patients with acute alcoholic hepatitis and identify those with severe disease requiring immediate treatment 1.
A Maddrey score ≥32 defines severe alcoholic hepatitis and mandates consideration of corticosteroid therapy, as patients face significant mortality risk without treatment 1.
Key Clinical Applications:
Calculate the Maddrey score in patients with suspected alcoholic hepatitis who present with jaundice and a history of heavy alcohol use (>40g/day for women, >50-60g/day for men) 1
The score identifies patients who need urgent intervention, as severe alcoholic hepatitis (MDF ≥32) carries high short-term mortality 1
Even "moderate" alcoholic hepatitis (MDF <32) carries substantial mortality: 10% at 6 months and 20% at 1 year, so these patients still require close monitoring and aggressive supportive care 1
Distinction from MELD Score
The Maddrey score is disease-specific for alcoholic hepatitis, whereas the MELD (Model for End-Stage Liver Disease) score is used more broadly for chronic liver disease and transplant prioritization 2, 3.
For Alcoholic Hepatitis Specifically:
Calculate both Maddrey score AND MELD score, as the MELD score (particularly ≥18-21) provides additional prognostic information about 90-day mortality risk 1
Use the Lille score on day 7 after initiating treatment to identify treatment responders (Lille ≥0.45 indicates non-responders) 1
Combined static (Maddrey/MELD at baseline) and dynamic (Lille at day 7) prognostication provides optimal risk stratification 1
Common Pitfall to Avoid
Do not confuse the Maddrey score with MELD score—they serve different purposes. The Maddrey score is exclusively for acute alcoholic hepatitis severity assessment, while MELD is the standard for general end-stage liver disease prognosis and transplant allocation 2, 3, 1.