MELD Score Surgical Risk — FRCA Final MCQ

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HardPreoperative AssessmentMELD Score Surgical RiskFRCA Final

A 62-year-old man (ASA III) with cirrhosis is scheduled for an umbilical hernia repair. His MELD score is 22. What does this MELD score predict regarding perioperative mortality for non-transplant abdominal surgery?

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Correct answer: B — ~25-30% perioperative mortality

The MELD (Model for End-stage Liver Disease) score uses bilirubin, INR, and creatinine to predict 90-day mortality in liver disease. For non-transplant surgery: MELD <10 = ~5% mortality; MELD 10-15 = ~10-15% mortality; MELD 16-20 = ~20-25% mortality; MELD 21-25 = ~25-35% mortality; MELD >25 = ~40-50% mortality. A MELD of 22 carries approximately 25-30% perioperative mortality risk. This information is essential for informed consent and risk-benefit discussions. Elective surgery should generally be deferred if MELD >15.

Reference: Teh SH et al – 2007 – MELD and surgical risk; RCOA – 2023 – Hepatobiliary anaesthesia