calculate_meld_score: Model for End-Stage Liver Disease (MELD) / MELD-Na

In cliot: Clinical Indices and Outcomes Tools

Model for End-Stage Liver Disease (MELD) / MELD-Na

Description

Calculates the MELD-Na score, used to prioritize candidates for liver transplantation and predict 3-month mortality in patients with end-stage liver disease. This function implements the 2016 OPTN/UNOS update which incorporates serum sodium for patients with an initial MELD > 11.

Usage

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

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).
bilirubin_units	String. "mg/dL" (default) or "umol/L".
creatinine_units	String. "mg/dL" (default) or "umol/L".

Value

A list containing:

MELD_Na_Score	The calculated MELD-Na score (capped at 40).
Est_3_Month_Mortality	Estimated 3-month mortality based on the score range.

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. 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.

Examples

# Example 1: MELD-Na Adjustment Applied
# Bili 2.0, INR 1.5, Cr 1.5, Na 125 (Low Na increases score)
calculate_meld_score(2.0, 1.5, 1.5, 125, 0)

# Example 2: Standard MELD (Score <= 11)
# Bili 1.0, INR 1.0, Cr 1.0, Na 135
# Score = 6
calculate_meld_score(1.0, 1.0, 1.0, 135, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.