Albumin-Bilirubin (ALBI) as an accurate and simple prognostic score for chronic hepatitis B-related liver cirrhosis

Dig Liver Dis. 2019 Aug;51(8):1172-1178. doi: 10.1016/j.dld.2019.01.011. Epub 2019 Jan 26.

Abstract

Background: The Albumin-Bilirubin (ALBI) score was developed to predict the long-term prognosis of hepatocellular carcinoma patients. We aimed to investigate the performance of ALBI for predicting severity and long-term prognosis of chronic hepatitis B-related liver cirrhosis (CHB-LC).

Methods: CHB-LC patients were enrolled from two medical centers between 2011 and 2017. The prognostic performance of ALBI was evaluated and compared with Child-Turcotte-Pugh (CTP), model of end-stage liver disease (MELD) and MELD integrating sodium (MELD-Na) scores.

Results: This study enrolled 398 CHB-LC patients and patients were followed up for a median of 33.9 (IQR 21.6-48.8) months. The ALBI (HR: 3.151, 95% CI: 2.039-4.869,P < 0.001) was identified as an independent predictor of liver-related mortality. The receiver operating characteristic curves (ROCs) analysis revealed that ALBI score (0.756, 0.745, 0.739, 0.767 and 0.765) was superior to MELD score (P < 0.05) and comparable with CTP score (P > 0.05) for predicting 2-year, 3-year, 4-year, 5-year and global mortality. The AUROCs of ALBI score were significantly higher than MELD-Na score(P < 0.05) for predicting 2-year, 3-year and 5-year mortality. Patients with lower ALBI grade had a significantly lower mortality than patients with higher ALBI grade (P < 0.05).

Conclusions: ALBI score accurately predicts the severity and long-term prognosis of patients with CHB-LC. The prognostic performance of ALBI score was superior to MELD and MELD-Na score.

Keywords: ALBI; CHB; Mortality; Noninvasive markers; Prediction.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Bilirubin / blood*
  • China / epidemiology
  • Female
  • Hepatitis B, Chronic / complications*
  • Humans
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / mortality*
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Serum Albumin / analysis*
  • Severity of Illness Index
  • Survival Analysis
  • Time Factors

Substances

  • Serum Albumin
  • Bilirubin