Model for end-stage liver disease

Background

• Used to predict mortality from cirrhosis
• An online calculator is available at MDCalc

Criteria

• Dialysis at least twice in the past week, or CVVHD for at least 24 hours in the past week
• Creatinine
• Bilirubin
• INR
• Sodium

Interpretation

• Calculates a score using a formula
  • MELD = (0.957 * ln(Creat) + 0.378 * ln(Bilirubin) + 1.120 * ln(INR) + 0.643 ) * 10
    • All values are in US units
    • If hemodialysis, value for Creatinine is automatically set to 353.6 umol/L (4 mg/dl)
  • MELD-Na = MELD - Na - 0.025*(MELD)*(140-Na) + 140

MELD-Na	90-day Mortality
<17	<2%
17 to 20	3 to 4%
21 to 22	7 to 10%
23 to 26	14 to 15%
27 to 31	27 to 32%
≥32	65 to 66%