MELD-Na_Score_guideline v.1
MELDNa/MELD-Na Score for Liver Cirrhosis uses the Na value to adapt the result and to provide a more specialized view and improves upon the MELD Score for liver cirrhosis, especially in regard to the mortality prediction.
To stratify severity of end-stage liver disease, for transplant planning.
Formula: Candidates who are at least 12 years old receive an initial MELD(i) score equal to: MELD(i) = 0.957 × ln(Cr) + 0.378 × ln(bilirubin) + 1.120 × ln(INR) + 0.643 Then, round to the tenth decimal place and multiply by 10. Additional rules: All values in US units (Cr and bilirubin in mg/dL, Na in mEq/L, and INR unitless). If bilirubin, Cr, or INR is <1.0, use 1.0. If any of the following is true, use Cr 4.0: Cr >4.0. ≥2 dialysis treatments within the prior 7 days. 24 hours of continuous veno-venous hemodialysis (CVVHD) within the prior 7 days. If Na <125 mmol/L, use 125. If Na >137 mmol/L, use 137.
Kim WR, Biggins SW, Kremers WK, Wiesner RH, Kamath PS, Benson JT, Edwards E, Therneau TM. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008 Sep 4;359(10):1018-26. doi: 10.1056/NEJMoa0801209. PMID: 18768945; PMCID: PMC4374557.
OBSERVATION.meld_score.v1, OBSERVATION.lab_test_creatinine.v1, OBSERVATION.lab_test-bilirubin.v1, OBSERVATION.inr.v0, OBSERVATION.lab_test-serum_sodium.v1, OBSERVATION.meld_na_score.v0, EVALUATION.meld_na_score_assessment.v0, OBSERVATION.basic_demographic.v1
