cliot (version 1.0.0)

meld_na_score_liver: MELD-Na Score for Liver Cirrhosis

Description

Calculates the MELD-Na (Model for End-Stage Liver Disease including Sodium) score. This version, adopted by OPTN/UNOS in 2016, incorporates serum sodium to better predict 3-month mortality in patients with end-stage liver disease, particularly those with hyponatremia.

Usage

meld_na_score_liver(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 (Range 6-40).

Est_3_Month_Mortality

Estimated 3-month mortality percentage.

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). If Yes, creatinine is set to 4.0 mg/dL.

bilirubin_units

String. Units for bilirubin input. "mg/dL" (default) or "umol/L".

creatinine_units

String. Units for creatinine input. "mg/dL" (default) or "umol/L".

References

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. doi:10.1056/NEJMoa0801209 OPTN/UNOS Policy Notice. Liver Policy: MELD Score / MELD-Na Score. 2016.

Examples

# Example 1: High Risk (Hyponatremia Effect)
# Bili 2.0, INR 1.5, Cr 1.5, Na 125 (Low Na increases score)
meld_na_score_liver(2.0, 1.5, 1.5, 125, 0)

# Example 2: Standard Risk
# Bili 1.0, INR 1.0, Cr 1.0, Na 138 (Na capped at 137)
# Score = 6
meld_na_score_liver(1.0, 1.0, 1.0, 138, 0)