MELD-Na Score

MELD-Na Score
This calculator provides the subsequent MELD scores for patients with cirrhosis.  [link memo="See also MELD score for initial testing (does not include sodium)" url="https://www.soapnote.org/digestive-system/meld/"]  [link memo="See also Child-Pugh Liver Failure Prognosis Calculator" url="https://www.soapnote.org/digestive-system/child-pugh-score/"]
[text name="bilirubin" size=5] <-- Bilirubin [comment memo="units are mg/dL"]
[text name="creatinine" size=5] <-- Serum Creatinine [comment memo="units are mg/dL"]
[text name="sodium" size=5] <-- Serum Sodium [comment memo="units are mg/dL"]
[text name="INR" size=5] <-- INR
[select value="no=0|YES=-1" name="dialysis"] <-- Has the patient had dialysis at least twice within the last week?
[conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isLess(1)&&(INR).isLess(1)&&(creatinine).isLess(1)"][calc show="false" value="score=6.431+(3.78*Math.log((1)))+(11.2 * Math.log((1)))+(9.57*Math.log((1)))+(9.57*(dialysis)*Math.log((1)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isLess(1)&&(INR).isLess(1)&&(creatinine).isGreater(4)"][calc show="false" value="score=6.431+(3.78*Math.log((1)))+(11.2 * Math.log((1)))+(9.57*Math.log((4)))+(9.57*(dialysis)*Math.log((4)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isLess(1)&&(INR).isLess(1)&&(creatinine).isGreaterOrEqual(1)&&(creatinine).isLessOrEqual(4)"][calc show="false" value="score=6.431+(3.78*Math.log((1)))+(11.2 * Math.log((1)))+(9.57*Math.log((creatinine)))+(9.57*(dialysis)*Math.log((creatinine)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isLess(1)&&(INR).isGreaterOrEqual(1)&&(creatinine).isLess(1)"][calc show="false" value="score=6.431+(3.78*Math.log((1)))+(11.2 * Math.log((INR)))+(9.57*Math.log((1)))+(9.57*(dialysis)*Math.log((1)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isLess(1)&&(INR).isGreaterOrEqual(1)&&(creatinine).isGreater(4)"][calc show="false" value="score=6.431+(3.78*Math.log((1)))+(11.2 * Math.log((INR)))+(9.57*Math.log((4)))+(9.57*(dialysis)*Math.log((4)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isLess(1)&&(INR).isGreaterOrEqual(1)&&(creatinine).isGreaterOrEqual(1)&&(creatinine).isLessOrEqual(4)"][calc show="false" value="score=6.431+(3.78*Math.log((1)))+(11.2 * Math.log((INR)))+(9.57*Math.log((creatinine)))+(9.57*(dialysis)*Math.log((creatinine)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isGreaterOrEqual(1)&&(INR).isLess(1)&&(creatinine).isLess(1)"][calc show="false" value="score=6.431+(3.78*Math.log((bilirubin)))+(11.2 * Math.log((1)))+(9.57*Math.log((1)))+(9.57*(dialysis)*Math.log((1)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isGreaterOrEqual(1)&&(INR).isLess(1)&&(creatinine).isGreater(4)"][calc show="false" value="score=6.431+(3.78*Math.log((bilirubin)))+(11.2 * Math.log((1)))+(9.57*Math.log((4)))+(9.57*(dialysis)*Math.log((4)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isGreaterOrEqual(1)&&(INR).isLess(1)&&(creatinine).isGreaterOrEqual(1)&&(creatinine).isLessOrEqual(4)"][calc show="false" value="score=6.431+(3.78*Math.log((bilirubin)))+(11.2 * Math.log((1)))+(9.57*Math.log((creatinine)))+(9.57*(dialysis)*Math.log((creatinine)))+(-13.267*(dialysis)"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isGreaterOrEqual(1)&&(INR).isGreaterOrEqual(1)&&(creatinine).isLess(1)"][calc show="false" value="score=6.431+(3.78*Math.log((bilirubin)))+(11.2 * Math.log((INR)))+(9.57*Math.log((1)))+(9.57*(dialysis)*Math.log((1)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isGreaterOrEqual(1)&&(INR).isGreaterOrEqual(1)&&(creatinine).isGreater(4)"][calc show="false" value="score=6.431+(3.78*Math.log((bilirubin)))+(11.2 * Math.log((INR)))+(9.57*Math.log((4)))+(9.57*(dialysis)*Math.log((4)))+(-13.267*(dialysis))"][/conditional][conditional field="INR|creatinine|bilirubin" condition="(bilirubin).isGreaterOrEqual(1)&&(INR).isGreaterOrEqual(1)&&(creatinine).isGreaterOrEqual(1)&&(creatinine).isLessOrEqual(4)"][calc show="false" value="score=6.431+(3.78*Math.log((bilirubin)))+(11.2 * Math.log((INR)))+(9.57*Math.log((creatinine)))+(9.57*(dialysis)*Math.log((creatinine)))+(-13.267*(dialysis))"][/conditional]MELD --> [calc memo="result" value="scoreNa=((score)+((1.32)*((137)-(sodium)))+((-0.033)*(score)*((137)-(sodium)))).toFixed(0)"] out of 40
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).isNot('')"]
References:
[link url="https://unos.org/" memo="#1"] United Network for Organ Sharing (UNOS) allocation page
[link url="http://www.ncbi.nlm.nih.gov/pubmed/12512033" memo="#2"] Wiesner (2003) Gastroenterology 124: 91-96
[link url="http://www.unos.org/docs/MELD_PELD_Calculator_Documentation.pdf" memo="#3"] UNOS documentation
[link url="https://optn.transplant.hrsa.gov/media/1575/policynotice_20151101.pdf" memo="#4"] Organ Procurement and Transplantation Network (OPTN) Policy Notice dated November 23, 2015 (advising use of MELD-Na for subsequent assessments).[/conditional]