Comparative evaluation of ALBI, MELD, and Child-Pugh scores in prognosis of cirrhosis: is ALBI the new alternative?

Abstract

Background The existence of reliable prognostic indices is of paramount importance in the management of cirrhosis. Both the model for end-stage liver disease (MELD) score and the older Child-Pugh (CP) scores are widely used. The albumin-bilirubin (ALBI) score, initially used in hepatocellular carcinoma, has not been thoroughly investigated in cirrhosis. The aim of this study was to compare the prognostic accuracy of ALBI, MELD, MELD with sodium (MELD-Na), CP, and the corrected for creatinine CP scores in a genetically homogeneous Cretan cirrhotic population. Methods One hundred ninety-five outpatients or hospitalized cirrhotics (127 male, median age 66 years) were studied over a period of 2 years and ALBI, platelet-albumin-bilirubin, MELD, MELD-Na, CP score, and 2 types of modified CP score (CP-I and CP-II) with serum creatinine were calculated and correlated with survival. Results ALBI had an optimum balance between sensitivity and specificity (area under the curve 0.704, 95% confidence interval [CI] 0.630-0.778) compared to the other scores. In the multivariate analysis, the only factors independently associated with death were the ALBI score (hazard ratio [HR] 2.51, 95%CI 1.69-3.73; P<0.001), the MELD-Na score (HR 1.04, 95%CI 1.00-1.09; P=0.045), and age (HR 1.05, 95%CI 1.03-1.07; P<0.001). When only decompensated cirrhosis was evaluated, the multivariate analysis showed that the ALBI score (HR 3.03; 95%CI 1.92-4.78; P<0.001), and age (HR 1.05, 95%CI 1.03-1.07; P<0.001) were independently associated with death. Conclusion ALBI score might be a better prognostic indicator of mortality in cirrhosis and given its simplicity could substitute for the CP, MELD, and MELD-Na scores.

Potential of Liver T₁ Mapping for the Detection of Fontan-associated Liver Disease in Adults

“…MELD XI and/or ALBI score (if the patient is on anticoagulants) are essential in screening for liver damage. [20][21][22][23] Additionally, the liver native T 1 values in our study showed good correlation with the two scores, suggesting that the liver native T 1 mapping may play an adjunct role in screening for FALD in adult Fontan patients. The prognostic significance of liver T 1 relaxometry requires further elucidation.…”

“…The MELD XI score = 11.76 × Ln (creatinine) + 5.11 × Ln (total bilirubin) + 9.44, and albumin-bilirubin (ALBI) score = [(log 10 bilirubin (μmol/L) × 0.66) + (albumin (g/L) × −0.085)], were determined as objective indicators of hepatic injury. 20,21 The MELD score is typically used to assess FALD; however, since adults Fontan patients are often prescribed with anticoagulants, we evaluated both the MELD XI, which excludes international normalized ratio (INR) and ALBI scores. 22,23 Twenty age-matched adults were enrolled as a control group.…”

Índices Prognósticos Não Convencionais Estão Relacionados Às Complicações Clínicas E Aos Índices Prognósticos Da Doença Hepática Crônica / Unconventional Prognostic Indexes Are Related to Clinical Complications and Prognostic Indexes of Chronic Liver Disease

“…[18][19][20] Fragaki, et al (2019), observaram que independentemente de etiologia, o escore o ALBI mostrou-se um preditor preciso e confiável na avaliação prognóstica de pacientes com cirrose descompensada, sendo igual ou superior a outros escores preditivos avaliados, como o MELD, CP e MELD-Na. 21 A adição da contagem de plaquetas ao escore ALBI, ocorre devido esse biomarcador estar relacionado ao efeito da hipertensão portal, que a principal causa de sangramento agudo das varizes esofágicas. Indicando que o poder prognóstico do ALBI seja maior em pacientes com disfunção hepática inicial, enquanto o PALBI tem melhor relação com a estratificação do risco de hipertensão portal.…”

Quantitative motor unit potential analysis and nerve conduction studies for detection of subclinical peripheral nerve dysfunction in patients with compensated liver cirrhosis

“…Detection of splenomegaly, ascites, and portosystemic collaterals was also possible. Doppler US was done for the hepatic and portal veins, hepatic artery, and intra-abdominal portosystemic collaterals [10]. (4) Neurological assessment: we used neuropathy symptom and change (NSC) score to test and grade the presence of PN.…”