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Validation of the albumin-bilirubin score for identifying decompensation risk in patients with compensated cirrhosis

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World Journal of Gastroenterology 2023年第32期29卷 4873-4882页

作者： Huttakan Navadurong Kessarin Thanapirom Salisa Wejnaruemarn Thaninee Prasoppokakorn Roongruedee Chaiteerakij Piyawat Komolmit Sombat Treeprasertsuk Division of Gastroenterology Department of MedicineFaculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkok 10330Thailand Department of Medicine Queen Savang Vadhana Memorial HospitalChonburi 20110Thailand

BACKGROUND The albumin-bilirubin(ALBI)score is an index of liver function recently developed to assess prognosis in patients with hepatocellular carcinoma(HCC).It can detect small changes in liver dysfunction and has been successfully applied to the prediction of survival in patients with non-malignant liver diseases of various *** To investigate the ALBI score for identifying decompensation risk at the 3-year follow-up in patients with compensated *** One-hundred and twenty-three patients with compensated cirrhosis without HCC in King Chulalongkorn Memorial Hospital diagnosed by imaging were retrospectively enrolled from January 2016 to December 2020.A total of 113 patients(91.9%)had Child A cirrhosis with a median model for end-stage liver disease(MELD)score of less than *** clinical and laboratory variables and decompensation events were *** ALBI score was calculated and validated to classify decompensation risk into low-,middle-,and high-risk groups using three ALBI grade ranges(ALBI grade 1:≤-2.60;grade 2:>-2.60 but≤-1.39;grade 3:>-1.39).decompensation events were defined as ascites development,variceal bleeding,or grade 3 or 4 hepatic *** Among 123 cirrhotic patients enrolled,13.8%(n=17)developed decompensating events at a median time of 25[95%confidence interval(CI):17-31]*** baseline ALBI score in compensated cirrhosis was significantly lower than that of patients who developed decompensation events[-2.768(-2.956 to-2.453)vs-2.007(-2.533 to-1.537);P=0.01].Analysis of decompensation risk at 3 years showed that ALBI score had a time-dependent area under the curve(tAUC)of 0.86(95%CI:0.78-0.92),which was significantly better than that of ALBI-Fibrosis-4(ALBI-FIB4)score(tAUC=0.77),MELD score(tAUC=0.66),Child-Pugh score(tAUC=0.65),and FIB-4 score(tAUC=0.48)(Pdecompensation was 3.1%,22.6%,and 50%in the low-,middle-,and high-risk groups,respectively(P

关键词： Albumin-bilirubin score Compensated cirrhosis hepatic decompensation risk

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