中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 7
Jul.  2021
Turn off MathJax
Article Contents

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

DOI: 10.3969/j.issn.1001-5256.2021.07.020
  • Received Date: 2021-01-30
  • Accepted Date: 2021-03-17
  • Published Date: 2021-07-20
  •   Objective  To investigate the value of platelet-albumin-bilirubin score (PALBI) in predicting the 30-day mortality of patients with liver cirrhosis and acute upper gastrointestinal bleeding (AUGIB).  Methods  A retrospective analysis was performed for the clinical data of 211 patients with liver cirrhosis who were admitted to Jinshan Hospital of Fudan University due to AUGIB from January 2016 to February 2020, and according to the survival status within 30 days, they were divided into death group with 24 patients and survival group with 187 patients. Epidemiological data (including age and sex) and laboratory examination results (including routine blood test results, hepatic and renal function, and coagulation function) were collected, and the scores of PALBI, albumin-bilirubin (ALBI), Child-Turcotte-Pugh (CTP), and Model for End-Stage Liver Disease (MELD) on admission were calculated and compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. With the application of 95% confidence interval, the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the predictive ability of the model. The DeLong test was used for comparison of ROC curve.  Results  Compared with the survival group, the death group had significantly higher PALBI score (-1.47±0.35 vs -1.94±0.36, P < 0.001), ALBI score (-0.74±0.49 vs -1.38±0.51, P < 0.001), CTP score (10.25±1.98 vs 8.06±1.70, P < 0.001), and MELD score (17.25±4.68 vs 11.63±4.83, P < 0.001). PALBI, ALBI, CTP, and MELD scores had an AUC of 0.827, 0.824, 0.790, and 0.811, respectively, and there was no significant difference in AUC between any two scores (P > 0.05).  Conclusion  PALBI score has good performance in predicting the 30-day mortality of patients with liver cirrhosis and AUGIB and is comparable to CTP and MELD scores.

     

  • loading
  • [1]
    XAVIER SA, VILAS-BOAS R, BOAL CARVALHO P, et al. 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[J]. Eur J Gastroenterol Hepatol, 2018, 30(6): 652-658. DOI: 10.1097/MEG.0000000000001087.
    [2]
    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(Suppl 1): 624A-690A. DOI: 10.1002/hep.28219.
    [3]
    JOHNSON PJ, BERHANE S, KAGEBAYASHI C, et al. Assessment of liver function in patients with hepatocellular carcinoma: A new evidence-based approach-the ALBI grade[J]. J Clin Oncol, 2015, 33(6): 550-558. DOI: 10.1200/JCO.2014.57.9151.
    [4]
    ZOU DL, QI XS, ZHU CH, et al. Albumin-bilirubin score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis: A retrospective study[J]. Turk J Gastroenterol, 2016, 27(2): 180-186. DOI: 10.5152/tjg.2016.15502.
    [5]
    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.
    [6]
    FREEMAN RB Jr, WIESNER RH, HARPER A, et al. The new liver allocation system: Moving toward evidence-based transplantation policy[J]. Liver Transpl, 2002, 8(9): 851-858. DOI: 10.1053/jlts.2002.35927.
    [7]
    CHILD ⅢCG, TURCOTTE JG. Surgery and portal hypertension[M]//In Child ⅢCG, ed. The liver and portal hypertension. Philadelphia: Saunders. 1964: 50.
    [8]
    PENG Y, QI XS, DAI JN, et al. Child-Pugh versus MELD score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis[J]. Int J Clin Exp Med, 2015, 8(1): 751-757. https://europepmc.org/articles/PMC4358508
    [9]
    LISMAN T, van LEEUWEN Y, ADELMEIJER J, et al. Interlaboratory variability in assessment of the Model of End-stage Liver Disease score[J]. Liver Int, 2008, 28(10): 1344-1351. DOI: 10.1111/j.1478-3231.2008.01783.x.
    [10]
    TROTTER JF, OLSON J, LEFKOWITZ J, et al. Changes in international normalized ratio (INR) and model for endstage liver disease (MELD) based on selection of clinical laboratory[J]. Am J Transplant, 2007, 7(6): 1624-1628. DOI: 10.1111/j.1600-6143.2007.01822.x.
    [11]
    HANSMANN J, EVERS MJ, BUI JT, et al. Albumin-bilirubin and platelet-albumin-bilirubin grades accurately predict overall survival in high-risk patients undergoing conventional transarterial chemoembolization for hepatocellular carcinoma[J]. J Vasc Interv Radiol, 2017, 28(9): 1224-1231. e2. DOI: 10.1016/j.jvir.2017.05.020.
    [12]
    LIU PH, HSU CY, HSIA CY, et al. ALBI and PALBI grade predict survival for HCC across treatment modalities and BCLC stages in the MELD Era[J]. J Gastroenterol Hepatol, 2017, 32(4): 879-886. DOI: 10.1111/jgh.13608.
    [13]
    LEE SK, SONG MJ, KIM SH, et al. Comparing various scoring system for predicting overall survival according to treatment modalities in hepatocellular carcinoma focused on Platelet-albumin-bilirubin (PALBI) and albumin-bilirubin (ALBI) grade: A nationwide cohort study[J]. PLoS One, 2019, 14(5): e0216173. DOI: 10.1371/journal.pone.0216173.
    [14]
    CHAN AWH, CHAN RCK, WONG GLH, et al. New simple prognostic score for primary biliary cirrhosis: Albumin-bilirubin score[J]. J Gastroenterol Hepatol, 2015, 30(9): 1391-1396. DOI: 10.1111/jgh.12938.
    [15]
    ITO T, ISHIGAMI M, MOROOKA H, et al. The albumin-bilirubin score as a predictor of outcomes in Japanese patients with PBC: An analysis using time-dependent ROC[J]. Sci Rep, 2020, 10(1): 17812. DOI: 10.1038/s41598-020-74732-3.
    [16]
    CHEN RC, CAI YJ, WU JM, et al. Usefulness of albumin-bilirubin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis[J]. J Viral Hepat, 2017, 24(3): 238-245. DOI: 10.1111/jvh.12638.
    [17]
    KOJI F, KYOKO O, HIROHITO Y, et al. Albumin-bilirubin score indicates liver fibrosis staging and prognosis in patients with chronic hepatitis C[J]. Hepatol Res, 2019, 49(7): 731-742. DOI: 10.1111/hepr.13333.
    [18]
    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.
    [19]
    ROBERTSON M, NG J, SHAWISH WA, 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.
  • 加载中

Catalog

    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

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(4)

    Article Metrics

    Article views (845) PDF downloads(85) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return