Calculate MELD scores — meld • ameld

Calculate MELD, MELD-Na scores and MELD or MELD-Plus score based survival probabilities.

meld(
  creatinine,
  bilirubin,
  inr,
  dialysis = FALSE,
  cause = "other",
  round = FALSE
)

meld_na(
  creatinine,
  bilirubin,
  inr,
  sodium,
  dialysis = FALSE,
  type = c("kim2008", "unos"),
  cause = "other",
  round = FALSE
)

meld3(
  creatinine,
  bilirubin,
  inr,
  sodium,
  albumin,
  female = TRUE,
  round = FALSE
)

pmeld(
  meld = NULL,
  creatinine,
  bilirubin,
  inr,
  dialysis = FALSE,
  cause = "other"
)

pmeld3(meld = NULL, creatinine, bilirubin, inr, sodium, albumin, female)

pmeld_plus7(
  creatinine,
  bilirubin,
  inr,
  sodium,
  albumin,
  wbc,
  age,
  round = FALSE
)

Arguments

creatinine: numeric, [mg/dl]
bilirubin: numeric, [mg/dl]
inr: numeric
dialysis: logical, had dialysis twice, or 24 hours of CVVHD, within a week prior to the serum creatinine test?
cause: character, cause of cirrhosis. Has to be of the same length as creatinine, bilirubin, inr and dialysis. Just "ethyltoxic", "cholestatic", "unos" and "other" are supported. Use "unos" for the United Network for Organ Sharing definition of the score.
round: logical, round to nearest integer?
sodium: numeric, [mmol/l]
type: character(1), type of implementation
albumin: numeric, [g/dl]
female: logical
meld: numeric, MELD/MELD-Na score as calculated by meld or meld-na.
wbc: numeric, [Gpt/l]
age: numeric, [years]

Value

numeric, MELD or MELD-Na score for meld and meld_na

respectively. pmeld and pmeld_plus7 return the survival probability based on the MELD and MELD-Plus7 score.

Details

Laboratory values (creatinine, bilirubin, INR) below 1.0 are set to 1.0 and creatinine above 4.0 is set to 4.0 as described in Wiesner et al. 2003.

The original MELD-Plus risk score reports a mortality probability. To provide a common interface with pmeld pmeld_plus7 returns a survival probabilitiy instead.

References

Michael Malinchoc et al. 2000. "A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts" Hepatology 31 (4): 864-871. doi:10.1053/he.2000.5852

United Network for Organ Sharing (UNOS). Policy notice 11/2015: OPTN executive committee actions. Available at: https://optn.transplant.hrsa.gov/media/1575/policynotice_20151101.pdf Accessed: September 11, 2019.

Kim et al. 2008. "Hyponatremia and Mortality among Patients on the Liver-Transplant Waiting List" N Engl J Med 2008; 359: 1018-1026 doi:10.1056/NEJMoa0801209

Kim et al. 2021. "MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era" Gastroenterology 2021; 161: 1887-1895.e4 doi:10.1053/j.gastro.2021.08.050

Wiesner et al. 2003. "Model for end-stage liver disease (MELD) and allocation of donor livers" Gastroentrology, 124 (1): 91-96 doi:10.1053/gast.2003.50016

Kartoun et al. 2017. "The MELD-Plus: A generalizable prediction risk score in cirrhosis" PloS one, 12 (10): e0186301 doi:10.1371/journal.pone.0186301

Examples

meld(creatinine = 1.9, bilirubin = 4.2, inr = 1.2, cause = "other")
#> [1] 20.03916

meld_na(creatinine = 1.9, bilirubin = 4.2, inr = 1.2, sodium = 135)
#> [1] 22.53427
meld_na(creatinine = 1.9, bilirubin = 4.2, inr = 1.2, sodium = 135,
        type = "unos")
#> [1] 21.35658

meld3(creatinine = 1.9, bilirubin = 4.2, inr = 1.2, sodium = 135, albumin = 3.5)
#> [1] 23.6327

pmeld(creatinine = 1.9, bilirubin = 4.2, inr = 1.2, cause = "other")
#> [1] 0.923248
pmeld(meld = 20)
#> [1] 0.9237187

pmeld3(meld = 20)
#> [1] 0.947061

pmeld_plus7(2.5, 4.1, 1.2, 137, 24, 6.7, 56)
#> [1] 0.9981954