4.5 Article

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

Journal

DIGESTIVE AND LIVER DISEASE
Volume 51, Issue 8, Pages 1172-1178

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2019.01.011

Keywords

ALBI; CHB; Mortality; Noninvasive markers; Prediction

Funding

  1. National Science and Technology Major Project of China [2018ZX10302205]
  2. National Natural Science Foundation of China [81672025, 81702011]
  3. Medical Science and Technology Development Foundation of Nanjing [ZDX16004, YKK16118]
  4. Nanjing Science and Technology Development Plan [201503016]
  5. Jiangsu Provincial Medical Innovation Team [CXTDA2017005]
  6. Natural Science Foundation of Jiangsu Province for Young Scholar [BK20160121]
  7. Nanjing Medical Science and Technique Development Foundation [QRX17121]
  8. Clinical Medical Center of Suzhou for Infectious Diseases [szzx201508]

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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. (C) 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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