A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and
Insights
The albumin-bilirubin (ALBI) score better predicts posthepatectomy liver failure (PHLF) in hepatocellular carcinoma (HCC) patients than other models. This finding suggests using the ALBI score to assess surgical risk for HCC patients undergoing liver resection.
Area of Science:
- Hepatology
- Surgical Oncology
- Medical Diagnostics
Background:
- The albumin-bilirubin (ALBI) grade is a novel model for assessing liver function.
- Existing models like Child-Pugh, MELD, and ICG R15 have limitations in predicting posthepatectomy liver failure (PHLF).
Purpose of the Study:
- To compare the predictive accuracy of the ALBI score against the Child-Pugh score, MELD score, and indocyanine green (ICG) R15 for PHLF.
- To evaluate the ALBI score's utility in assessing surgical risk for hepatocellular carcinoma (HCC) patients undergoing liver resection.
Main Methods:
- A cohort of 473 HCC patients undergoing curative resection between January 2014 and June 2017 was analyzed.
- The predictive performance of ALBI, Child-Pugh, MELD scores, and ICG R15 for PHLF was assessed using area under the curve (AUC) and multivariable analyses.
Main Results:
- The ALBI score demonstrated a superior AUC (0.745) in predicting PHLF compared to Child-Pugh (0.665), MELD (0.649), and ICG R15 (0.668).
- ALBI was an independent predictor of PHLF across all hepatectomy subgroups.
- Child-Pugh and MELD scores were not significant predictors in major or minor hepatectomy subgroups, while ICG R15 was only significant in minor hepatectomy.
Conclusions:
- The ALBI score exhibits superior predictive capability for PHLF compared to established scoring systems.
- The study recommends the ALBI score as a valuable tool for evaluating surgical risk in HCC patients undergoing hepatic resection.
Background:
The albumin-bilirubin (ALBI) grade is a newly proposed model for assessing the hepatic function. This study aimed to compare the value of the ALBI score with Child-Pugh score, model for end-stage liver disease (MELD) score and indocyanine green (ICG) R15 in predicting posthepatectomy liver failure (PHLF).
Methods:
Patients undergoing curative resection for hepatocellular carcinoma (HCC) between January 2014 and June 2017 were enrolled. The values of the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were evaluated.
Results:
A total of 473 HCC patients were enrolled. The ALBI score was identified as an independent predictor of PHLF. The AUCs for the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were 0.665, 0.649, 0.668, and 0.745 respectively. Multivariable analyses revealed that the ALBI score was an independent predictor of PHLF regardless of the hepatectomy subgroups, but the Child-Pugh score and MELD score were not significant predictors of PHLF both in major and minor hepatectomy subgroups, and ICG R15 was only a significant predictor of PHLF in minor hepatectomy subgroup.
Conclusion:
The ALBI score showed superior predictive value of PHLF over Child-Pugh score, MELD score and ICG R15. We propose to use the ALBI score to evaluate surgical risk for HCC patients undergoing hepatic resection.
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