Kartoun et al reported the MELD-Plus score for accurate prediction of mortality of a patient with cirrhosis. This can help to identify a patient who may require more aggressive management or liver transplant. The authors are from Harvard Medical School, Massachusetts General Hospital and IBM Research.
Patient selection: adult with a cirrhosis-related hospital admission
Parameters:
(1) serum total bilirubin in mg/dL
(2) serum creatinine in mg/dL
(3) serum albumin in g/dL
(4) INR
(5) WBC count in 10^3/µL
(6) number of nights spent in hospital
(7) age in years
(8) serum sodium in mmol/L
(9) serum total cholesterol in mg/dL
|
Parameter
|
Points
|
|
serum total bilirubin
|
2.076192 * LOG10(1 + (total bilirubin))
|
|
serum creatinine
|
2.494291 * LOG10(1 + (creatinine))
|
|
serum albumin
|
-6.049540 * LOG10(1 + (albumin))
|
|
INR
|
2.525905* LOG10(1 + (INR))
|
|
WBC count
|
1.911856 * LOG10(1 + (WBC))
|
|
number of nights
|
0.015411 * (nights)
|
|
age in years
|
0.041047 * (years)
|
|
serum sodium
|
-6.62570 * LOG10(1 + (sodium))
|
|
serum total cholesterol
|
-1.445666 * LOG10(1 + (total cholesterol))
|
where:
• There are 2 ways to handle the WBC count - per µL vs 10^3 per µL. The latter is used in the implementation since those units are shown in Table 1.
score =
= SUM(points for all of the parameters) + 11.794383
probability of 90-day mortality =
= 1 / (1 + EXP((-1) * (score)))
Performance:
• The area under the ROC curve is 0.78.
