Description

Kartoun et al reported the MELD-Plus score for accurate prediction of mortality of a patient with cirrhosis. This can be simplified by removal of 2 of the 9 parameters. The authors are from Harvard Medical School, Massachusetts General Hospital and IBM Research.


Patient selection: adult with a cirrhosis-related hospital admission

 

Difference from complete model: removal of total cholesterol and length of stay (nights)

 

Parameters:

(1) serum total bilirubin in mg/dL

(2) serum creatinine in mg/dL

(3) serum albumin in g/dL

(4) INR

(5) WBC count in 10^3/µL

(6) age in years

(7) serum sodium in mmol/L

 

Parameter

Points

serum total bilirubin

2.06503238 * LOG10(1 + (total bilirubin))

serum creatinine

2.5967965 * LOG10(1 + (creatinine))

serum albumin

-6.34990436 * LOG10(1 + (albumin))

INR

2.99724802* LOG10(1 + (INR))

WBC count

1.92811726* LOG10(1 + (WBC))

age in years

0.04070442 * (years)

serum sodium

-6.47834101 * LOG10(1 + (sodium))

 

where:

• There are 2 ways to handle the WBC count - per µL vs 10^3 per µL. The latter is used in the implementation since those units are shown in Table 1.

 

score =

= SUM(points for all of the parameters) + 8.53499496

 

probability of 90-day mortality =

= 1 / (1 + EXP((-1) * (score)))

 

Performance:

• The area under the ROC curve is 0.77.


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