cliot (version 1.0.0)

meld_score_original: Model for End-Stage Liver Disease (MELD) Score (Original, Pre-2016)

Description

Calculates the original MELD score used to assess the severity of end-stage liver disease and predict 3-month mortality. This version uses Creatinine, Bilirubin, and INR. Note: The United Network for Organ Sharing (UNOS) updated their policy in 2016 to use the MELD-Na score for transplant prioritization.

Usage

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

Value

A list containing:

MELD_Score

The calculated 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.

on_dialysis

Numeric (0 or 1). Has the patient had dialysis at least twice in the past week? (1 = Yes). If Yes, creatinine is capped at 4.0 mg/dL.

bilirubin_units

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

creatinine_units

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

Details

The formula is: $$MELD = 10 \times (0.957 \times \ln(Creatinine) + 0.378 \times \ln(Bilirubin) + 1.120 \times \ln(INR) + 0.643)$$ Any value less than 1.0 is set to 1.0. Creatinine is capped at 4.0 mg/dL.

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. doi:10.1053/jhep.2001.22172

Examples

# Example 1: Low Risk
# Bili 1.0, INR 1.0, Cr 1.0
# Score = 6
meld_score_original(1.0, 1.0, 1.0)

# Example 2: High Risk
# Bili 5.0, INR 2.0, Cr 2.5
# Score = 26
meld_score_original(5.0, 2.0, 2.5)