Yan et al reported an integrated MELD score for patients with HBV-related acute-on-chronic liver failure (ACLF). This can help to identify a patient who may require more aggressive management. The authors are from Zhejiang University and affiliated hospitals.
NOTE: This score is different than the iMELD score of Luca et al for patients with cirrhosis.
Patient selection: acute-on-chronic liver failure (ACLF) due to hepatitis B virus (HBV)
Parameters:
(1) MELD score
(2) age in years
(3) hepatic encephalopathy (HE), graded by West Haven criteria from 1 to 4
• Hepatic encephalopathy was divided into 3 groups in Table 2 (0; 1 or 2; 3 or 4). It is assumed that the HE score is 0, 1 or 2 based on this grouping.
• The coefficient assignment is shown in Table 3.
Interpretation:
• The higher the iMELD score the worse the outcome.
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