/MELD Score

MELD Score

Model for End-Stage Liver Disease (Pre-2016)

Bilirubin
mg/dL
INR
Creatinine
mg/dL

Total Score

6

Estimated 3-month mortality: ~1.9%.

0–9+Low
10–19+Moderate
20–29+High
30–39+High
40–99+High

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.

Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.

Clinical Overview

The MELD (Model for End-Stage Liver Disease) score is an objective, lab-based scoring system used to predict 3-month mortality in patients with advanced chronic liver disease. Relying purely on objective lab values (Bilirubin, Creatinine, INR, and recently Sodium), it serves as the primary tool for prioritizing patients on the liver transplant waiting list.

Clinical Pearl

The inclusion of Serum Sodium (MELD-Na) significantly improved the score's accuracy, as dilutional hyponatremia is a hallmark of severe portal hypertension and splanchnic vasodilation. A patient with a seemingly stable MELD but refractory hyponatremia is at extreme risk.

Pitfalls & Warnings

  • The score can artificially drop if a patient receives fresh frozen plasma (improving INR) prior to the blood draw.
  • In patients requiring dialysis (≥2 times in the past week), the creatinine level is automatically set to 4.0 mg/dL in the calculation, maximizing that component.

Academic References

Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464-470.

Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130(6):1652-1660.

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.