MELD Score: Difference between revisions
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The equation is: | The equation is: | ||
:<math>\mbox{MELD}= 6.43 + 3.78 | :<math>\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)</math> | ||
An [http://www.unos.org/resources/MeldPeldCalculator.asp?index=98 online calculator] is available. | An [http://www.unos.org/resources/MeldPeldCalculator.asp?index=98 online calculator] is available. | ||
Adding the serum sodium to the calculation may improve accuracy.<ref name="pmid18768945">{{cite journal |author=Kim WR, Biggins SW, Kremers WK, ''et al'' |title=Hyponatremia and mortality among patients on the liver-transplant waiting list |journal=N. Engl. J. Med. |volume=359 |issue=10 |pages=1018–26 |year=2008 |month=September |pmid=18768945 |doi=10.1056/NEJMoa0801209 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18768945&promo=ONFLNS19 |issn=}}</ref> | |||
==Interpretation== | ==Interpretation== | ||
Revision as of 18:35, 8 September 2008
The MELD score can help predict mortality in patients with cirrhosis and end-stage liver disease.
Calculation
The equation is:
An online calculator is available.
Adding the serum sodium to the calculation may improve accuracy.[1]
Interpretation
In interpeting the MELD Score in hospitalized patients, the 3 month mortality is:[2]
- 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).[3]
In preoperative care, the MELD Score can help predict complications of surgery among patients with cirrhosis.[4] The MELD Score may [5] or may not[6] perform better than the Child-Turcotte-Pugh class.
References
- ↑ Kim WR, Biggins SW, Kremers WK, et al (September 2008). "Hyponatremia and mortality among patients on the liver-transplant waiting list". N. Engl. J. Med. 359 (10): 1018–26. DOI:10.1056/NEJMoa0801209. PMID 18768945. Research Blogging.
- ↑ Kamath PS, Wiesner RH, Malinchoc M, et al (2001). "A model to predict survival in patients with end-stage liver disease". Hepatology 33 (2): 464–70. DOI:10.1053/jhep.2001.22172. PMID 11172350. Research Blogging.
- ↑ Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC (2000). "A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts". Hepatology 31 (4): 864–71. DOI:10.1053/he.2000.5852. PMID 10733541. Research Blogging.
- ↑ Teh SH, Nagorney DM, Stevens SR, et al (April 2007). "Risk factors for mortality after surgery in patients with cirrhosis". Gastroenterology 132 (4): 1261–9. DOI:10.1053/j.gastro.2007.01.040. PMID 17408652. Research Blogging.
- ↑ Farnsworth N, Fagan SP, Berger DH, Awad SS (November 2004). "Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients". Am. J. Surg. 188 (5): 580–3. DOI:10.1016/j.amjsurg.2004.07.034. PMID 15546574. Research Blogging.
- ↑ Suman A, Barnes DS, Zein NN, Levinthal GN, Connor JT, Carey WD (August 2004). "Predicting outcome after cardiac surgery in patients with cirrhosis: a comparison of Child-Pugh and MELD scores". Clin. Gastroenterol. Hepatol. 2 (8): 719–23. PMID 15290666. [e]