MELD Score: Difference between revisions
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The '''MELD score''' can help predict mortality in patients with [[cirrhosis]] and end-stage liver disease. | The '''MELD score''' can help predict mortality in patients with [[cirrhosis]] and end-stage liver disease. | ||
==Calculation== | |||
The equation is: | |||
:<math>\mbox{MELD}= 6.43 + 3.78 * \mbox{ln} \left({\mbox{bilirubin mg/dL}}\right) + 9.57 * \mbox{ln} \left({\mbox{creatinine mg/dl}}\right) + 11.2 * \mbox{ln} \left({\mbox{INR}}\right)</math> | :<math>\mbox{MELD}= 6.43 + 3.78 * \mbox{ln} \left({\mbox{bilirubin mg/dL}}\right) + 9.57 * \mbox{ln} \left({\mbox{creatinine mg/dl}}\right) + 11.2 * \mbox{ln} \left({\mbox{INR}}\right)</math> | ||
An [http://www.unos.org/resources/MeldPeldCalculator.asp?index=98 online calculator] is available. | |||
==Interpretation== | |||
In interpeting the MELD Score in hospitalized patients, the 3 month mortality is:<ref name="pmid11172350">{{cite journal |author=Kamath PS, Wiesner RH, Malinchoc M, ''et al'' |title=A model to predict survival in patients with end-stage liver disease |journal=Hepatology |volume=33 |issue=2 |pages=464–70 |year=2001 |pmid=11172350 |doi=10.1053/jhep.2001.22172}}</ref> | In interpeting the MELD Score in hospitalized patients, the 3 month mortality is:<ref name="pmid11172350">{{cite journal |author=Kamath PS, Wiesner RH, Malinchoc M, ''et al'' |title=A model to predict survival in patients with end-stage liver disease |journal=Hepatology |volume=33 |issue=2 |pages=464–70 |year=2001 |pmid=11172350 |doi=10.1053/jhep.2001.22172}}</ref> | ||
* 40 or more - 100% mortality | * 40 or more - 100% mortality | ||
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The MELD has also been studied in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS).<ref name="pmid10733541">{{cite journal |author=Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC |title=A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts |journal=Hepatology |volume=31 |issue=4 |pages=864–71 |year=2000 |pmid=10733541 |doi=10.1053/he.2000.5852}}</ref> | The MELD has also been studied in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS).<ref name="pmid10733541">{{cite journal |author=Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC |title=A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts |journal=Hepatology |volume=31 |issue=4 |pages=864–71 |year=2000 |pmid=10733541 |doi=10.1053/he.2000.5852}}</ref> | ||
The [[MELD Score]] can help predict complications of surgery among patients with [[cirrhosis]].<ref name="pmid17408652">{{cite journal |author=Teh SH, Nagorney DM, Stevens SR, ''et al'' |title=Risk factors for mortality after surgery in patients with cirrhosis |journal=Gastroenterology |volume=132 |issue=4 |pages=1261–9 |year=2007 |month=April |pmid=17408652 |doi=10.1053/j.gastro.2007.01.040 |url=http://linkinghub.elsevier.com/retrieve/pii/S0016-5085(07)00179-5 |issn=}}</ref> The MELD Score may <ref name="pmid15546574">{{cite journal |author=Farnsworth N, Fagan SP, Berger DH, Awad SS |title=Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients |journal=Am. J. Surg. |volume=188 |issue=5 |pages=580–3 |year=2004 |month=November |pmid=15546574 |doi=10.1016/j.amjsurg.2004.07.034 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9610(04)00367-8 |issn=}}</ref> or may not<ref name="pmid15290666">{{cite journal |author=Suman A, Barnes DS, Zein NN, Levinthal GN, Connor JT, Carey WD |title=Predicting outcome after cardiac surgery in patients with cirrhosis: a comparison of Child-Pugh and MELD scores |journal=Clin. Gastroenterol. Hepatol. |volume=2 |issue=8 |pages=719–23 |year=2004 |month=August |pmid=15290666 |doi= |url= |issn=}}</ref> perform better than the Child-Turcotte-Pugh class. | |||
==References== | ==References== | ||
Revision as of 11:22, 19 May 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.
Interpretation
In interpeting the MELD Score in hospitalized patients, the 3 month mortality is:[1]
- 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).[2]
The MELD Score can help predict complications of surgery among patients with cirrhosis.[3] The MELD Score may [4] or may not[5] perform better than the Child-Turcotte-Pugh class.
References
- ↑ 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]