MELD Score Calculator (MELD-Na) for Cirrhosis
Enter the bilirubin, INR, creatinine and sodium and get the MELD-Na score with the bounds applied correctly, plus what the number actually means for your patient.
The formula and the bounds
MELD = 3.78×ln(bilirubin) + 11.2×ln(INR) + 9.57×ln(creatinine) + 6.43
MELD-Na = MELD + 1.32×(137 − Na) − 0.033×MELD×(137 − Na)
The bounds matter and this calculator applies them: any lab below 1.0 is set to 1.0 (a log of a number under 1 would reward abnormally good labs), creatinine caps at 4.0, dialysis sets creatinine to 4.0, sodium is bounded between 125 and 137, and the sodium adjustment only applies when MELD is above 11. The final score is rounded and bounded 6 to 40.
What the number means
MELD-Na estimates 90 day mortality in cirrhosis and orders the transplant waiting list. The working bands: a score under 10 is compensated disease managed in clinic; the mid teens is where transplant evaluation conversations start and where 90 day mortality becomes a real number; above 20 is sick, and above 30 is ICU-level disease with very high short term mortality. Exception points exist for hepatocellular carcinoma and a few other conditions, which is why the number on the list is not always the number from the labs.
At the bedside, the score is also a trigger: a MELD that jumps means something happened. Look for the GI bleed, the sepsis, the new AKI from overdiuresis, or spontaneous bacterial peritonitis. The hepatology consult goes better when you present the trend and the precipitant together, in the format from the consult note guide. Sodium handling in these patients is its own trap: correct slowly, per the sodium correction rules.
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These are the printable PDF scut sheets we use on the wards: admit sheets and daily progress notes laid out in the exact order you present on rounds, patient trackers with an active problem list and separate columns for home and hospital medications, a ten patient sheet for bigger lists, and a cardiology and telemetry note. Print them double sided, fold them into your pocket, and stop rewriting the same information three times a day.
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This is not medical advice. This calculator is an educational tool. Transplant listing decisions use the official OPTN calculation and current lab values. Verify against your institution's resources.