The albumin-bilirubin score as a predictor of outcomes in Japanese patients with PBC: an analysis using time-dependent ROC

Sci Rep. 2020 Oct 20;10(1):17812. doi: 10.1038/s41598-020-74732-3.

Abstract

The albumin-bilirubin (ALBI) score is calculated using only serum albumin and bilirubin levels, and was developed as a simple method to assess hepatic function. In this study, a total of 409 patients with primary biliary cholangitis (PBC) were enrolled between March 1990 and October 2018. The predictive performances of the ALBI score and other well-established prognostic scores were compared using time-dependent receiver operating characteristic (ROC) analysis. During the follow-up period, 60 patients died, 45 due to liver-related diseases and 15 due to non-liver-related diseases, and 16 patients underwent liver transplantation. Time-dependent ROC analysis showed that the ALBI score has higher the areas under the ROC curves (AUROCs) than the Child-Pugh (C-P) score at each time point; AUROCs at 3, 5, and 10 years after the start of follow-up were 0.94, 0.91, and 0.90 for the ALBI score, and 0.89, 0.88, and 0.82 for the C-P score, respectively. The ALBI score showed the highest AUROCs within 2 years after the start of observation; beyond 2 years, however, the Mayo score had better prognostic ability for mortality and liver transplantation. The ALBI score/grade, derived from objective blood tests, and the Mayo score were superior prognostic tools in PBC patients.

MeSH terms

  • Aged
  • Bilirubin / blood*
  • Follow-Up Studies
  • Humans
  • Japan
  • Liver / metabolism*
  • Liver / pathology
  • Liver Cirrhosis, Biliary / diagnosis*
  • Liver Cirrhosis, Biliary / mortality
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Serum Albumin / metabolism*
  • Survival Analysis
  • Treatment Outcome

Substances

  • Serum Albumin
  • Bilirubin