Description

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

 

score =

= (0.104 * (MELD)) + (1.759 * (HE score)) + (0.030 * (age))

 

where:

• 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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