3-month mortality in advanced liver disease; transplant prioritization. Free to use.
MELD-Na (Model for End-Stage Liver Disease — Sodium) is a validated clinical instrument used to assess 3-month mortality in advanced liver disease; transplant prioritization. The instrument contains 5 items.
Source / attribution: Kim WR et al., NEJM 2008 (UNOS implementation 2016)
Like all screening or assessment instruments, MELD-Na is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 5 items below to see your MELD-Na score and interpretation.
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MELD-Na uses a published formula (meld-na) rather than simple summation. The formula and its inputs are visible in our open-source scoring engine.
Scoring notes: Educational use only. Floors and caps applied per UNOS rules.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 6–9 | Low | Lower mortality risk. |
| 10–19 | Moderate | Moderate mortality risk. |
| 20–29 | High | High mortality risk. |
| 30–40 | Very high | Very high mortality risk. |
MELD-Na uses a published formula rather than simple summation. Below is a step-by-step calculation with illustrative inputs.
| Input | Value |
|---|---|
| Bilirubin | 2.0 mg/dL |
| INR | 1.5 |
| Creatinine | 1.5 mg/dL |
| Sodium | 135 mEq/L |
Score = 19 → Moderate — Moderate mortality risk.
If MELD-Na doesn't fit your context, related instruments in gastroenterology include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| Child-Pugh | Severity of cirrhosis and prognosis | 5 | — |
| Glasgow-Blatchford | Pre-endoscopy risk in upper GI bleeding | 9 | — |
| ASA Physical Status | Pre-operative health status | 1 | — |
| Barthel Index | Functional independence in ADLs | 10 | — |
| BDI-II | Severity of depression | — | ≈ 5 minutes |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
| CURB-65 | 30-day mortality in community-acquired pneumonia | 5 | — |
| Glasgow Coma Scale | Level of consciousness after head injury | 3 | — |
MELD-Na (Model for End-Stage Liver Disease — Sodium) is a validated instrument that assesses 3-month mortality in advanced liver disease; transplant prioritization. It is designed for clinicians, medical students, evidence-synthesis researchers. The 5 items are combined to produce a total score.
MELD-Na contains 5 items. Items feed into a scoring formula that produces the total. Scores run from 6 to 40, grouped into 4 interpretation bands from ‘Low’ up to ‘Very high’.
On the MELD-Na (total score 6–40), scores of 30–40 fall in the ‘Very high’ band — interpreted as: Very high mortality risk. The full ladder is: 6–9 — Low: Lower mortality risk.; 10–19 — Moderate: Moderate mortality risk.; 20–29 — High: High mortality risk.; 30–40 — Very high: Very high mortality risk. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 6–9 fall in the ‘Low’ band: Lower mortality risk. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
Yes — MELD-Na is in the public domain and free for clinical, educational, and research use without permission. You can use this calculator and the scale itself freely; if you publish results or reproduce the scale, cite the original source paper.
Kim WR et al. N Engl J Med. 2008;359(10):1018-1026. This is the original publication for the MELD-Na — the reference to cite when reporting results.
No. MELD-Na is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of 3-month mortality in advanced liver disease; transplant prioritization — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
MELD-Na is supported by the following peer-reviewed sources: