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Albumin-bilirubin score a reliable predictor of long-term prognosis in CHB-LC

09 Aug 2019

The albumin-bilirubin (ALBI) score is an accurate predictor of long-term prognosis in patients with chronic hepatitis B-related liver cirrhosis (CHB-LC), a recent study has shown.

The study included 398 CHB-LC patients (median age, 50.0 years; 73.4 percent male) in whom the prognostic performance of ALBI score was assessed and compared to that of the Child-Turcotte-Pugh (CTP), model of end-stage liver disease (MELD) and MELD with sodium (MELD-Na) scores. The main outcome was liver-related mortality.

Participants with decompensated cirrhosis had significantly higher ALBI scores than those with compensated disease (–1.8 vs –2.6; p<0.001). Similar trends were reported for the CTP, MELD and MELD-Na scores, though only ALBI was consistently correlated with the presence of decompensating events, such as ascites, hepatic encephalopathy and oesophageal variceal bleeding.

The importance of ALBI was verified through multivariable Cox proportional hazard regression analysis, which identified the score as a significant predictor of mortality (hazard ratio, 3.151, 95 percent CI, 2.039–4.869; p<0.001).

As a predictive model, ALBI garnered an area under the receiver operating characteristic (AUROC) curve value of 0.700, which was comparable to that of CTP (AUROC, 0.731), MELD (AUROC, 0.677) and MELD-Na (AUROC, 0.683) for the prediction of 1-year liver-related mortality.

However, ALBI significantly outperformed both the MELD and MELD-Na scores for the prediction of 2-year (AUROC, 0.756 vs 0.655 and 0.662), 3-year (AUROC, 0.745 vs 0.629 and 0.646) and 5-year (AUROC, 0.767 vs 0.636 and 0.651) liver-related mortality. No such superiority over CTP score was reported.

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