New simple prognostic score for primary biliary cirrhosis: Albumin-bilirubin score

• Published in: Journal of gastroenterology and hepatology 2015-09, Vol.30 (9), p.1391-1396
• Main Authors: Chan, Anthony W H, Chan, Ronald C K, Wong, Grace L H, Wong, Vincent W S, Choi, Paul C L, Chan, Henry L Y, To, Ka-Fai
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bilirubin - blood; Biomarkers - blood; Child-Pugh score; Cohort Studies; Diagnostic Techniques, Digestive System; European model; Female; Follow-Up Studies; hepatic event; Humans; Liver Cirrhosis, Biliary - blood; Liver Cirrhosis, Biliary - diagnosis; Longitudinal Studies; Male; Mayo risk score; MELD; Middle Aged; Multivariate Analysis; Newcastle model; Prognosis; Proportional Hazards Models; Retrospective Studies; Serum Albumin - analysis; survival; Yale model
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.12938

Background and Aim Serum albumin and bilirubin are the most significant independent prognostic factors to predict hepatic events in patients with primary biliary cirrhosis (PBC). We aimed to investigate the prognostic significance of a new prognostic score, the albumin‐bilirubin (ALBI) score, among PBC patients. Methods In a retrospective longitudinal cohort of 61 Chinese PBC patients with follow‐up period up to 18.3 years, the prognostic performance of the ALBI in prediction of hepatic events was compared with other well‐established prognostic scores: Child–Pugh score, model of end‐stage liver disease, Mayo risk score, Yale, European, and Newcastle models. Results Fifteen patients (24.6%) developed hepatic events during follow‐up. The c‐index (0.894) and χ2 by likelihood ratio test (36.34) of the ALBI score were highest in comparison to other models. The ALBI score was the only independent prognostic factor by multivariate analysis and its adjusted hazard ratio of developing hepatic event was 27.8 (P  −2.60 to −1.39), and grade 3 (> −1.39) groups. The 2‐, 5‐, and 10‐year event‐free survivals for grade 1, grade 2, and grade 3 groups were 100.0% versus 100.0% versus 57.1%, 100.0% versus 88.5% versus 14.3%, and 100.0% versus 81.7% versus 0.0%, respectively (P