Kim et al reported the MELD 3.0 score as an improved version of the Model for End-Stage Liver Disease for use in liver transplant patients. The authors are from Stanford University, Mayo Clinic, Baylor University (Dallas), University of Washington Seattle, and the United States Naval Academy.
Parameters:
(1) sex
(2) serum total bilirubin in mg/dL
(3) serum sodium in mmol/L
(4) INR
(5) serum creatinine in mg/dL
(6) serum albumin in g/dL
Parameter
Finding
Points
sex
male
0
female
1.33
total bilirubin
4.56 * LN(bilirubin)
serum sodium
0.82 * (137 - (sodium))
INR
9.09 * LN(INR)
creatinine
11.14 * LN(creatinine)
albumin
1.85 * (3.5 - (albumin))
sodium and bilirubin
-0.24 * (137 - (sodium)) * LN(bilirubin)
albumin and creatinine
-1.83 * (3.5 - (albumin)) * LN(creatinine)
MELD 3 =
= SUM(points for all of the parameters) + 6
Interpretation:
• The median score was 19 in the study population.
• maximum score: > 40
Multivariate Cox Proportional Hazard Regression
Survival Period
Survival (0)
15 days
0.991
30 days
0.981
45 days
0.971
60 days
0.963
75 days
0.955
90 days
0.946
X =
= (0.17698 * (score)) - 3.56
survival at 90 days =
= 0.946 ^ EXP(X)
Performance:
• The C-statistic for 90-day mortality was 0.87.
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