TAILIEUCHUNG - MELD score

The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease. It was initially developed to predict death within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. This score is now used by the United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score. . | MELD score The Model for End-Stage Liver Disease or MELD is a scoring system for assessing the severity of chronic liver disease. It was initially developed to predict death within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt TIPS procedure and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. This score is now used by the United Network for Organ Sharing UNOS and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score. Determination MELD uses the patient s values for serum bilirubin serum creatinine and the international normalized ratio for prothrombin time INR to predict survival. It is calculated according to the following formula 3 MELD Ln serum bilirubin mg dL Ln INR Ln serum creatinine mg dL UNOS has made the following modifications to the score 5 If the patient has been dialyzed twice within the last 7 days then the value for serum creatinine used should be Any value less than one is given a value of 1 . if bilirubin is a value of is used to prevent the occurrence of scores below 0 the natural logarithm of 1 is 0 and any value below 1 would yield a negative result Patients with a diagnosis of liver cancer will be assigned a MELD score based on how advanced the cancer is. This staging system is known as the TNM system. T stands for the local extent of the tumor N stands for the presence or absence of lymph node metastases and M stands for the presence or absence of distant metastasis tumor spread to another organ such as the lung in the case of liver cancer . Interpretation In interpreting the MELD Score in hospitalized patients the 3 month mortality is 40 or more 100 mortality 30-39 83 mortality 20-29 76 mortality 10-19 27 mortality 10 4 mortality History MELD was originally developed at the Mayo Clinic and at that point was called the Mayo End-stage Liver .

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