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

作　　者：Huttakan Navadurong Kessarin Thanapirom Salisa Wejnaruemarn Thaninee Prasoppokakorn Roongruedee Chaiteerakij Piyawat Komolmit Sombat Treeprasertsuk 

机构地区：[1]Division of Gastroenterology,Department of Medicine,Faculty of Medicine,Chulalongkorn University and King Chulalongkorn Memorial Hospital,Thai Red Cross Society,Bangkok 10330,Thailand [2]Department of Medicine,Queen Savang Vadhana Memorial Hospital,Chonburi 20110,Thailand

出　　处：《World Journal of Gastroenterology》2023年第32期4873-4882,共10页世界胃肠病学杂志（英文版）

摘　　要：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 etiologies.AIM To investigate the ALBI score for identifying decompensation risk at the 3-year follow-up in patients with compensated cirrhosis.METHODS 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 9.Baseline clinical and laboratory variables and decompensation events were collected.The 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 encephalopathy.RESULTS Among 123 cirrhotic patients enrolled,13.8%(n=17)developed decompensating events at a median time of 25[95%confidence interval(CI):17-31]mo.Median 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)(P<0.05 for all).The 3-year cumulative incidence of decompensation was 3.1%,22.6%,and 50%in the low-,middle-,and high-risk groups,respectively(P<0.001).The odds ratio for decompensation in

关 键 词：Albumin-bilirubin score Compensated cirrhosis Hepatic decompensation risk 

分 类 号：R575.2[医药卫生—消化系统]