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Category: Volume 09 Issue 04 April 2021
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Title: Albumin- Bilirubin (ALBI) Score a New and Simple Bedside Model to Predict Mortality in Patients with Cirrhosis

Authors: Ravikumar. P, Caroline Selvi, Premkumar, A. Chezhian, R Murali , I. Shubha

 DOI: https://dx.doi.org/10.18535/jmscr/v9i4.03

Abstract

Aim: The existence of reliable prognostic indices is of paramount importance in the management of cirrhosis. The albumin-bilirubin (ALBI) score is a new model for assessing the severity of liver dysfunction. The aim of this study was to determine the ALBI score’s mortality prediction among cirrhotics and its comparison with MELD, CTP scores.

Methods: This prospective study included one hundred cirrhotics where we calculated CTP, MELD and ALBI scores were calculated within 24 hours of admission. The mortality was assessed during the hospital stay and follow-up at 2, 4 and 6 months. The diagnostic accuracy of CTP, MELD and ALBI scores for mortality in cirrhotic patients was determined by receiver operating characteristic curve (ROC) analysis.

Results: In the overall analysis, all of the three scores were significantly assess the mortality (CTP AUC=0.917, 95% CI: 0.857–0.977, P<0.0001; MELD AUC=0.935, 95% CI: 0.887–0.982, P<0.0001; ALBI AUC =0.964, 95% CI: 0.924–1.003, P<0.0001). The best cut-off values for CTP, MELD and ALBI were at >12.5 (sensitivity = 75.86%, specificity = 97.18%), >22.5 (sensitivity = 100%, specificity = 84.51%) and >-1.38 (sensitivity = 100%, specificity = 94.37%) with diagnostic accuracy of 91%, 89% and 96% respectively.

Conclusion: The fact that ALBI score uses only two convenient parameters, readily obtained by easily accessible blood tests, objectively evaluated and being non inferior to CTP and MELD scores indicates that ALBI score might be a better mortality predictor in cirrhosis. Therefore, all these favour its applicability in clinical practice as a substitute for the CTP and MELD scores.

Keywords:  Bilirubin, Albumins , Prognosis, Liver Cirrhosis.

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Corresponding Author

Ravikumar. P

Madras Medical College, Chennai