DF = 4.6 × (PT – Control PT) + Total Bilirubin (mg/dL)
The DF score is calculated using simple laboratory parameters to predict 30-day mortality in alcoholic hepatitis, helping guide treatment decisions and identify patients who may benefit from corticosteroid therapy.
Discriminant Function Calculator
Alcoholic Hepatitis Prognostic Tool
What is the Discriminant Function for Alcoholic Hepatitis?
The Discriminant Function (DF) is a prognostic scoring system specifically designed for patients with alcoholic hepatitis. It helps clinicians identify patients at high risk for short-term mortality who may benefit from specific treatments like corticosteroids.
The DF score is calculated using simple laboratory parameters to predict 30-day mortality in alcoholic hepatitis, helping guide treatment decisions and identify patients who may benefit from corticosteroid therapy.
Clinical Significance
Alcoholic hepatitis is a severe form of alcohol-related liver injury with high short-term mortality. The DF score helps stratify patients by risk, identifying those with severe disease (DF ≥32) who have significantly higher mortality and may benefit from specific interventions.
Calculation Parameters
The DF score is calculated using three laboratory values:
| Parameter | Significance |
|---|---|
| Prothrombin Time (PT) | Measures blood clotting ability; prolonged PT indicates impaired liver synthetic function |
| Control Prothrombin Time | Laboratory reference value for normal PT |
| Total Bilirubin | Measures liver’s ability to process bile; elevated levels indicate severe liver injury |
Discriminant Function Formula
Where PT and Control PT are measured in seconds, and bilirubin is measured in mg/dL.
Clinical Application
The DF score is primarily used to identify patients with severe alcoholic hepatitis (DF ≥32) who may benefit from corticosteroid therapy. Several clinical trials have shown that patients with DF ≥32 who receive corticosteroids have improved short-term survival compared to those who do not.
Discriminant Function Calculator
Enter the patient’s laboratory values to calculate the DF score and assess 30-day mortality risk in alcoholic hepatitis.
Score Interpretation
DF scores are categorized into risk levels with associated clinical implications:
Treatment Implications
Based on the DF score and clinical assessment:
- DF < 32: Focus on alcohol abstinence, nutritional support, and management of complications
- DF ≥ 32: Consider prednisolone (40 mg/day for 28 days) after excluding contraindications like active infection, gastrointestinal bleeding, or renal failure
Limitations and Considerations
While the DF score is a valuable prognostic tool, it should be used in conjunction with:
- Clinical assessment for signs of hepatic decompensation
- Evaluation for contraindications to corticosteroid therapy
- Assessment of other prognostic scores like MELD or GAHS
- Consideration of patient preferences and overall clinical context
Note: This calculator provides an estimate based on the standard DF calculation. Treatment decisions should always be made in consultation with a hepatology specialist considering the complete clinical picture.
