Value of platelet-albumin-bilirubin index combined with AIMS65 score in predicting the short-term prognosis of patients with liver cirrhosis and acute upper gastrointestinal bleeding

Tianjiao DAI; Jing LI

doi:10.12449/JCH240213

Volume 40 Issue 2

Feb. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2024 > 40(2): 298-305

PDF( 909 KB)

Value of platelet-albumin-bilirubin index combined with AIMS65 score in predicting the short-term prognosis of patients with liver cirrhosis and acute upper gastrointestinal bleeding

DOI: 10.12449/JCH240213

Tianjiao DAI¹,
Jing LI^{2
,
,
,}

1.
Postgraduate Training Base, The First Affiliated Hospital of Jinzhou Medical University，Jinzhou，Liaoning 121000，China
2.
Second Ward of Gastroenterology，The First Affiliated Hospital of Jinzhou Medical University，，Jinzhou，Liaoning 121000，China

Research funding:

Liaoning Science and Technology Plan Project (2021JH2/10300042)

More Information

Corresponding author: LI Jing， jz7203@139.com （ORCID： 0000-0001-8283-5789）
Received Date: 2023-04-22
Accepted Date: 2023-07-10
Published Date: 2024-02-19

Abstract

Abstract

Objective To investigate the value of platelet-albumin-bilirubin index （PALBI） combined with AIMS65 score in predicting rebleeding and death within 6 weeks after admission in patients with liver cirrhosis and acute upper gastrointestinal bleeding （AUGIB）. Methods A retrospective study was conducted for 238 patients with liver cirrhosis and AUGIB who were hospitalized in The First Affiliated Hospital of Jinzhou Medical University from February 2021 to October 2022， and all patients were followed up for 6 weeks. According to the prognosis， they were divided into death group with 65 patients and survival group with 173 patients， and according to the presence or absence of rebleeding， they were divided into non-rebleeding group with 149 patients and rebleeding group with 89 patients. General data and laboratory markers （including blood routine， liver/renal function， and coagulation）， and PALBI， AIMS65 score， Child-Turcotte-Pugh （CTP） score， and Model for End-stage Liver Disease （MELD） score were calculated on admission. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. A multivariate logistic regression model analysis was used to investigate the risk factors for death or rebleeding within 6 weeks after admission in patients with liver cirrhosis and AUGIB. The receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC） were used to investigate the predictive efficacy of each scoring system， and the DeLong test was used for comparison of AUC. Results There were significant differences between the death group and the survival group in hematemesis， past history of varices， albumin （Alb）， total bilirubin （TBil）， international normalized ratio （INR）， creatinine （Cr）， prothrombin time （PT）， systolic blood pressure， PALBI， AIMS65 score， CTP score， and MELD score （all P<0.05）. The multivariate logistic regression analysis showed that hematemesis （odds ratio ［OR］=4.34， 95% confidence interval ［CI］： 1.88‍ ‍—‍ ‍10.05， P<0.001）， past history of varices （OR=3.51， 95%CI： 1.37‍ ‍—‍ ‍8.98， P=0.009）， PALBI （OR=4.49， 95%CI： 1.48‍ ‍—‍ ‍13.64， P=0.008）， and AIMS65 score （OR=3.85， 95%CI： 2.35‍ ‍—‍ ‍6.30， P<0.001） were independent risk factors for death. The ROC curve analysis of each scoring system in predicting survival showed that CTP score， MELD score， PALBI， AIMS65 score， and PALBI combined with AIMS65 score had an AUC of 0.758， 0.798， 0.789， 0.870， and 0.888， respectively， suggesting that PALBI combined with AIMS65 score had a significantly larger AUC than the four scoring systems used alone （all P<0.05）. There were significant differences between the rebleeding group and the non-rebleeding group in hematemesis， history of diabetes， Alb， TBil， INR， Cr， PT， PALBI， AIMS65 score， CTP score， and MELD score （all P<0.05）. The multivariate logistic regression analysis showed that PALBI （OR=2.41， 95%CI： 1.17‍ ‍—‍ ‍4.95， P=0.017） and AIMS65 score （OR=1.58， 95%CI： 1.17‍ ‍—‍ ‍2.15， P=0.003） were independent risk factors for rebleeding. The ROC curve analysis of each scoring system in predicting rebleeding showed that CTP score， MELD score， PALBI， AIMS65 score， and PALBI combined with AIMS65 score had an AUC of 0.680， 0.719， 0.709， 0.711， and 0.741， respectively， suggesting that PALBI combined with AIMS65 score had the largest AUC （all P<0.05）， but with a relatively low specificity. Conclusion PALBI combined with AIMS65 score has a certain value in predicting death within 6 weeks after admission in patients with liver cirrhosis and AUGIB， with a better value than CTP score and MELD score alone. PALBI combined with AIMS65 score has a relatively low value in predicting rebleeding within 6 weeks， with an acceptable accuracy.
- Liver Cirrhosis,
- Acute Upper Gastrointestinal Bleeding,
- PALBI Score,
- AIMS65 Score,
- Prognosis

FullText(HTML)

References(20)

References

[1]	CHANDNA S, ZARATE ER, GALLEGOS-OROZCO JF. Management of decompensated cirrhosis and associated syndromes[J]. Surg Clin North Am, 2022, 102( 1): 117- 137. DOI: 10.1016/j.suc.2021.09.005.
[2]	WU X, ZHANG XJ, XUE Y, et al. Changes and clinical significance of blood antithrombin-III and D-dimer levels in liver cirrhosis patients with gastrointestinal bleeding[J/CD]. Chin J Liver Dis(Electronic Version), 2023, 15( 1): 56- 61. DOI: 10.3969/j.issn.1674-7380.2023.01.009. 武幸, 张秀军, 薛源, 等. 肝硬化消化道出血患者血抗凝血酶Ⅲ和D-二聚体水平变化及临床意义[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 1): 56- 61. DOI: 10.3969/j.issn.1674-7380.2023.01.009.
[3]	ZHANG K, LIU JL, LIU YL, et al. Clinical effect of transjugular intrahepatic portosystemic shunt guided by the three-dimensional model constructed using thin-slice CT scan data in treatment of cirrhotic portal hypertension with gastrointestinal bleeding[J]. Clin J Med Offic, 2023, 51( 6): 655- 656, 660. DOI: 10.16680/j.1671-3826.2023.06.28. 张凯, 刘晶磊, 刘燚隆, 等. 应用CT薄层扫描数据电脑构建3D模型指导经颈静脉肝内门体分流术治疗肝硬化门脉高压合并消化道出血临床效果观察[J]. 临床军医杂志, 2023, 51( 6): 655- 656, 660. DOI: 10.16680/j.1671-3826.2023.06.28.
[4]	JAKAB SS, GARCIA-TSAO G. Evaluation and management of esophageal and gastric varices in patients with cirrhosis[J]. Clin Liver Dis, 2020, 24( 3): 335- 350. DOI: 10.1016/j.cld.2020.04.011.
[5]	Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006. 中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
[6]	OIKONOMOU T, GOULIS L, DOUMTSIS P, et al. ALBI and PALBI grades are associated with the outcome of patients with stable decompensated cirrhosis[J]. Ann Hepatol, 2019, 18( 1): 126- 136. DOI: 10.5604/01.3001.0012.7904.
[7]	ROBERTSON M, NG J, SHAWISH W ABU, et al. Risk stratification in acute variceal bleeding: Comparison of the AIMS65 score to established upper gastrointestinal bleeding and liver disease severity risk stratification scoring systems in predicting mortality and rebleeding[J]. Dig Endosc, 2020, 32( 5): 761- 768. DOI: 10.1111/den.13577.
[8]	FREEMAN R. The new liver allocation system: Moving toward evidence-based transplantation policy[J]. Liver Transplant, 2002, 8( 9): 851- 858. DOI: 10.1053/jlts.2002.35927.
[9]	CHILD CG, TURCOTTE JG. Surgery and portal hypertension[J]. Major Probl Clin Surg, 1964, 1: 1- 85.
[10]	GARCIA-TSAO G, ABRALDES JG, BERZIGOTTI A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases[J]. Hepatology, 2017, 65( 1): 310- 335. DOI: 10.1002/hep.28906.
[11]	Chinese Society of Spleen and Portal Hypertension Surgery, Chinese Society of Surgery, Chinese Medical Association. Expert consensus on diagnosis and treatment of esophagogastric variceal bleeding in cirrhotic portal hypertension(2019 edition)[J]. Chin J Pract Surg, 2019, 39( 12): 1241- 1247. DOI: 10.19538/j.cjps.issn1005-2208.2019.12.01. 中华医学会外科学分会脾及门静脉高压外科学组. 肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2019版)[J]. 中国实用外科杂志, 2019, 39( 12): 1241- 1247. DOI: 10.19538/j.cjps.issn1005-2208.2019.12.01.
[12]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Endoscopy, Chinese Medical Association. Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol, 2016, 32( 2): 203- 219. DOI: 10.3969/j.issn.1001-5256.2016.02.002. 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2016, 32( 2): 203- 219. DOI: 10.3969/j.issn.1001-5256.2016.02.002.
[13]	Chinese Society of Hepatology, Chinese Society of Gastroenterology, and Chinese Society of Digestive Endoscopology of Chinese Medical Association. Guidelines on the management of esophagogastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol, 2023, 39( 3): 527- 538. 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会消化内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2023, 39( 3): 527- 538.
[14]	TANDON P, BISHAY K, FISHER S, et al. Comparison of clinical outcomes between variceal and non-variceal gastrointestinal bleeding in patients with cirrhosis[J]. J Gastroenterol Hepatol, 2018, 33( 10): 1773- 1779. DOI: 10.1111/jgh.14147.
[15]	LANAS A, DUMONCEAU JM, HUNT RH, et al. Non-variceal upper gastrointestinal bleeding[J]. Nat Rev Dis Primers, 2018, 4: 18020. DOI: 10.1038/nrdp.2018.20.
[16]	LI YY, LI HY, ZHU Q, et al. Effect of acute upper gastrointestinal bleeding manifestations at admission on the in-hospital outcomes of liver cirrhosis: Hematemesis versus melena without hematemesis[J]. Eur J Gastroenterol Hepatol, 2019, 31( 11): 1334- 1341. DOI: 10.1097/MEG.0000000000001524.
[17]	MANDAL AK, PAUDEL MS, KC S, et al. Factors predicting mortality of acute variceal bleeding in liver cirrhosis[J]. JNMA J Nepal Med Assoc, 2018, 56( 209): 493- 496.
[18]	GARCIA-TSAO G, BOSCH J. Varices and variceal hemorrhage in cirrhosis: A new view of an old problem[J]. Clin Gastroenterol Hepatol, 2015, 13( 12): 2109- 2117. DOI: 10.1016/j.cgh.2015.07.012.
[19]	ROAYAIE S, JIBARA G, BERHANE S, et al. 851 PALBI-An objective score based on platelets, albumin bilirubin stratifies HCC patients undergoing resection& ablation better than Child’s classification[J]. Hepatology, 2015, 62: 624- 690.
[20]	ELSHAARAWY O, ALLAM N, ABDELSAMEEA E, et al. Platelet-albumin-bilirubin score- a predictor of outcome of acute variceal bleeding in patients with cirrhosis[J]. World J Hepatol, 2020, 12( 3): 99- 107. DOI: 10.4254/wjh.v12.i3.99.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(2) / Tables(8)

Get Citation

PDF

XML

Article Metrics

Article views (165) PDF downloads(33)

Value of platelet-albumin-bilirubin index combined with AIMS65 score in predicting the short-term prognosis of patients with liver cirrhosis and acute upper gastrointestinal bleeding

DOI: 10.12449/JCH240213

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Value of platelet-albumin-bilirubin index combined with AIMS65 score in predicting the short-term prognosis of patients with liver cirrhosis and acute upper gastrointestinal bleeding

DOI: 10.12449/JCH240213

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content