cliot (version 1.0.0)

calculate_meld_score: Model for End-Stage Liver Disease (MELD) / MELD-Na

Description

Calculates the MELD-Na score, used to prioritize candidates for liver transplantation and predict 3-month mortality in patients with end-stage liver disease. This function implements the 2016 OPTN/UNOS update which incorporates serum sodium for patients with an initial MELD > 11.

Usage

calculate_meld_score(bilirubin, inr, creatinine, sodium, on_dialysis = 0,
                     bilirubin_units = "mg/dL", creatinine_units = "mg/dL")

Value

A list containing:

MELD_Na_Score

The calculated MELD-Na score (capped at 40).

Est_3_Month_Mortality

Estimated 3-month mortality based on the score range.

Arguments

bilirubin

Numeric. Total bilirubin level.

inr

Numeric. International Normalized Ratio.

creatinine

Numeric. Serum creatinine level.

sodium

Numeric. Serum sodium level (mEq/L).

on_dialysis

Numeric (0 or 1). Has the patient had dialysis at least twice in the past week? (1 = Yes).

bilirubin_units

String. "mg/dL" (default) or "umol/L".

creatinine_units

String. "mg/dL" (default) or "umol/L".

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. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018-1026.

Examples

# Example 1: MELD-Na Adjustment Applied
# Bili 2.0, INR 1.5, Cr 1.5, Na 125 (Low Na increases score)
calculate_meld_score(2.0, 1.5, 1.5, 125, 0)

# Example 2: Standard MELD (Score <= 11)
# Bili 1.0, INR 1.0, Cr 1.0, Na 135
# Score = 6
calculate_meld_score(1.0, 1.0, 1.0, 135, 0)