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MELD Score

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MELD Score, Model for End-Stage Liver Disease

  • Indications
  1. Cirrhosis Prognosis
  2. Liver Transplantation Evaluation
  • Criteria
  1. Serum Bilirubin
  2. INR
  3. Serum Creatinine
  4. Cirrhosis Etiology
    1. Alcohol or Cholestasis: 0
    2. Other etiologies: 1
  • Protocol
  • Calculation
  1. MELD = 3.8 (Ln Bilirubin) + 11.2 (Ln INR) + 9.6 (Ln Creatinine) + 6.4 (etiology)
    1. Where Ln is logorithm
  • Interpretation
  • Postoperative Mortality for patients with Cirrhosis
  1. Score 0-5
    1. Mortality at 7 days: 0.6%
    2. Mortality at 30 days: 3.2%
    3. Mortality at 90 days: 7.1%
  2. Score 6-10
    1. Mortality at 7 days: 2.8%
    2. Mortality at 30 days: 8.6%
    3. Mortality at 90 days: 13.9%
  3. Score 11-15
    1. Mortality at 7 days: 7.2%
    2. Mortality at 30 days: 21.9%
    3. Mortality at 90 days: 30.6%
  4. Score 16-20
    1. Mortality at 7 days: 14.6%
    2. Mortality at 30 days: 44.0%
    3. Mortality at 90 days: 55.8%
  5. Score 21-25
    1. Mortality at 7 days: 22.2%
    2. Mortality at 30 days: 55.6%
    3. Mortality at 90 days: 66.7%
  6. Score >26
    1. Mortality at 7 days: 25.0%
    2. Mortality at 30 days: 87.5%
    3. Mortality at 90 days: 87.5%
  7. References
    1. Teh (2007) Gastroenterology [PubMed]