MELD Score

The MELD Score (Model for End-Stage Liver Disease Score) can help predict mortality in patients with cirrhosis and end-stage liver disease.

Calculation

The equation is:

${\mbox{MELD}}=6.43+3.78\times {\mbox{ln}}\left({\mbox{bilirubin mg/dL}}\right)+9.57\times {\mbox{ln}}\left({\mbox{creatinine mg/dl}}\right)+11.2\times {\mbox{ln}}\left({\mbox{INR}}\right)$

An online calculator is available.

Adding the serum sodium to the calculation may improve accuracy.

Interpretation

In interpreting the MELD Score in hospitalized patients, the 3 month mortality is:

• 40 or more - 100% mortality
• 30-39 - 83% mortality
• 20-29 - 76% mortality
• 10-19 - 27% mortality
• <10 - 4% mortality

The MELD has also been studied in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS).

In preoperative care, the MELD Score can help predict complications of surgery among patients with cirrhosis. The MELD Score may or may not perform better than the Child-Turcotte-Pugh classification.

Variations

iMELD

${\mbox{iMELD}}={\text{MELD}}+0.3*{\mbox{ age in years}}\ -0.7*{\mbox{sodium mEq/L}}+100$

MELD-Na

${\mbox{MELD-Na}}={\text{MELD}}+1.59\left(135-{\text{sodium mEq/L}}\right)$

MESO (maximum and minimum values of sodium are 135 and 120 mEq/L)

${\mbox{MESO}}={\frac {\text{MELD}}{\text{sodium mEq/L}}}\times 100$

MELD-XI

${\mbox{MELD-XI}}=5.11\times \ln \left({\text{bilirubinemia mg/dl}}\right)+11.76\ln \left({\text{creatinine mg/dl}}\right)+9.44$

External links

• Online calculator