Assessment of prognostic performance of Albumin–Bilirubin, Child–Pugh, and Model for End-stage Liver Disease scores in patients with liver cirrhosis complicated with acute upper gastrointestinal bleeding

Xavier, Sofıa; Vilas-Boas, Ricardo de Souza; Carvalho, Pedro Boal; Magalhães, Joana; Marinho, Carla; Cotter, José

doi:10.1097/meg.0000000000001087

Cited by 41 publications

(33 citation statements)

References 26 publications

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“…Decompensated cirrhosis is a common disease with high morbidity and may be accompanied by several manifestations of decompensation, including gastrointestinal hemorrhage, hepatic encephalopathy, and infection. Consistent with a previous study on patients with liver cirrhosis, approximately 11.0% of patients with decompensated cirrhosis died within 28 days and 20% died within 6 months in the present study [26][27][28]. To reduce mortality, it is crucial to recognize those patients with a potentially poor prognosis and then prioritize and treat them accordingly in an appropriate and timely manner.…”

Section: Discussionsupporting

confidence: 87%

“…Lei et al's study shows that ALBI scores are consistent with the Child-Pugh score and the MELD scores in predicting value of patients with hepatitis B-related liver disease [14]. Similar to the conclusion of Xavier et al's study, we found that the ALBI score has a better performance than the Child-Pugh score and the MELD scores in predicting short-term prognosis, especially in patients with acute decompensation of cirrhosis [28]. Xavier et al's study mainly focused on patients with cirrhosis complicated by acute upper gastrointestinal bleeding, which is similar to the cause of hospitalization in this study.…”

Section: Disease Markerssupporting

confidence: 88%

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Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

et al. 2020

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Background and Aim. Various methods, including the Child-Pugh score, the model for end-stage liver disease (MELD) score, the MELD combined with serum sodium concentration (MELD-Na) score, the integrated MELD (iMELD) score, and the albumin-bilirubin (ALBI) score, have been widely used for predicting the survival of decompensated cirrhosis (DeCi) patients. In this study, we defined and compared the prognostic value of these scores to predict mortality in DeCi patients. Methods. We performed a single-center, observational retrospective study and analyzed 456 DeCi patients who were hospitalized in the gastroenterology department. The biochemical examination results and demographic characteristics of the patients were obtained, and five scores were calculated upon admission after 24 hours. All patients were observed until death, loss to follow-up, or specific follow-up times (28 days, 90 days, and 6 months). A receiver operating characteristic (ROC) curve was used to evaluate the ability of these methods to predict mortality in DeCi patients. Results. At 28 days, 90 days, and 6 months, the cumulative number of deaths was 50 (11.0%), 76 (16.6%), and 91 (19.9%), respectively. The scores were significantly higher in nonsurviving patients than in surviving patients. All scores yielded viable values in predicting 28-day, 90-day, and 6-month prognoses for DeCi patients. The areas under the ROC curve (AUROCs) of the ALBI score were higher than those of the other scores, which were only over 0.700 at 28 days. The AUROC of the MELD score was higher than that of the other scores, including the MELD-Na and iMELD scores, at 90 days and 6 months. Conclusion. All five methods (Child-Pugh score, MELD score, MELD-Na score, iMELD score, and ALBI score) provided a reliable prediction of mortality for both the short-term and long-term prognosis of patients with DeCi. The ALBI score may be particularly useful for assessing short-term outcomes, whereas the MELD score may be particularly useful for assessing long-term outcomes.

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Section: Discussionsupporting

confidence: 87%

Section: Disease Markerssupporting

confidence: 88%

Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

et al. 2020

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“…Positive correlations was also found between the ALBI score and the CTP score (r= +0.576, p< 0.001) [26]. Strong positive correlation between the ALBI and the CTP score (r = 0.759, p< 0.01) was evident [20]. These results are consistent with the current study.…”

Section: Discussionsupporting

confidence: 91%

“…This result is not consistent with the present study. In a study observed among 111 cirrhotic patients during assessing prognostic performance of ALBI score in Portugal among other scores, the mean± SD of serum albumin (g/dl), serum bilirubin (mg/dl), prothrombin time (sec) and INR were 2.6±0.6, 2.5±2.4, 17.5±3.9, 1.6±0.4 respectively [20]. These findings are nearly similar with our study.…”

Section: Discussionsupporting

confidence: 91%

"Correlation of Albumin-Bilirubin (ALBI) Score with Child-Turcotte-Pugh (CTP) Score in the Evaluation of Liver Cirrhosis "

Shafiq¹,

Khan²,

Majumder³

et al. 2019

AJLM

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Cirrhosis of liver is characterized by the replacement of normal liver tissue by scar tissue. The Child-Turcotte-Pugh (CTP) score is used to assess the prognosis of cirrhosis and included five factors: total bilirubin level, serum albumin, prothrombin time, ascites and hepatic encephalopathy. CTP score depends on clinical assessment which may result variation in scoring. Recently a new score is introduced, Albumin-Bilirubin (ALBI) score which may be done instead of CTP scoring in cirrhotic patient. This cross sectional study was conducted at the Department of Laboratory Medicine in collaboration with the Department of Hepatology, BSMMU, Dhaka, from March 2018 to February 2019. Blood samples were assayed from eighty one diagnosed cirrhotic patients. For all statistical analysis SPSS version 22 was used. The mean age of the study group was 46.1±16.0 years. 64.2% were male and 35.8% were female. Kappa (k) value was 0.759 between ALBI and CTP score. Pearson's correlation coefficient (r) test showed significant strong positive correlation between CTP score and ALBI score (r=+0.853, p<0.001). This study concluded that the ALBI score may be done alternative to the CTP score in cirrhotic patient because it's simple, two parameters only, more evidence based and more objective.

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“…27 Although ALBI score was introduced to assess the liver function in patients with HCC, 28 yet different recent studies proved its usefulness in predicting complication and survival for patients with liver cirrhosis when complicated with acute liver failure, 29 or acute UGIB. 30 More recently, its use in the assessment of patients undergoing living donor transplantation was studied. 31 ALBI score, compared with the traditional MELD and CP scores, is more simple, easy, and readily comparable.…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post‐therapeutic outcome and prognostic indicators

Fouad

Abdelsameea

Abdel-Razek

et al. 2019

J of Gastro and Hepatol

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Background and Aim Upper gastrointestinal bleeding (UGIB) is a serious complication of portal hypertension in cirrhotic patients. The objective of this study is to identify the risk factors for morbidity and mortality occurring after an UGIB attack. Methods A total of 1097 UGIB attacks in 690 patients with liver cirrhosis were studied. Their clinical, laboratory, and endoscopic data were reviewed. Results Mean age 53.2 ± 10.6 (20–90) years, 78% men and the main cause of liver disease was hepatitis C (94.9%). Complications occurred after 467 attacks (42.6%): hepatic encephalopathy 31.4%, spontaneous bacterial peritonitis 18%, renal impairment 13.2%, and re‐bleeding in 7.8%, while 199 patients (18.1%) died. Complications followed 78.4% of bleeding from gastric varices, 75% of post‐interventional ulcers, 10.8% of peptic ulcers, and 5.9% of telangiectasias. By univariate analysis: packed red blood cells units transfused, transaminases, Child–Pugh (CP), model of end‐stage liver disease (MELD), and albumin–bilirubin (ALBI) scores, beside the presence of hepatocellular carcinoma (HCC), previous hemorrhage in the previous 6 months, and the source of bleeding, were associated with occurrence of complications. By multivariate analysis, independent predictors of complications were CP, MELD, and ALBI scores (odds ratio, 95% confidence interval: 5.63, 3.55–8.93; 1.15, 1.11–1.19; and 2.11, 1.4–3.19, respectively) beside the presence of HCC (4.89, 2.48–9.64). Mortality predictors were packed red blood cells units transfused (1.11, 1.01–1.24), CP (5.1, 1.42–18.25) MELD (1.27, 1.21–1.32) scores, and presence of HCC (6.62, 2.93–14.95). Conclusion High CP, MELD, and ALBI scores beside the presence of HCC could predict poor outcome of UGIB. In the absence of these risk factors, early discharge could be considered if the source of bleeding is peptic ulcer or telangiectasia.

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Assessment of prognostic performance of Albumin–Bilirubin, Child–Pugh, and Model for End-stage Liver Disease scores in patients with liver cirrhosis complicated with acute upper gastrointestinal bleeding

Cited by 41 publications

References 26 publications

Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

"Correlation of Albumin-Bilirubin (ALBI) Score with Child-Turcotte-Pugh (CTP) Score in the Evaluation of Liver Cirrhosis "

Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post‐therapeutic outcome and prognostic indicators

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Assessment of prognostic performance of Albumin–Bilirubin, Child–Pugh, and Model for End-stage Liver Disease scores in patients with liver cirrhosis complicated with acute upper gastrointestinal bleeding

Cited by 41 publications

References 26 publications

Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

&quot;Correlation of Albumin-Bilirubin (ALBI) Score with Child-Turcotte-Pugh (CTP) Score in the Evaluation of Liver Cirrhosis &quot;

Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post‐therapeutic outcome and prognostic indicators

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"Correlation of Albumin-Bilirubin (ALBI) Score with Child-Turcotte-Pugh (CTP) Score in the Evaluation of Liver Cirrhosis "