MELD Score
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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]