Value of platelet-albumin-bilirubin score in predicting the short-term prognosis of patients with liver cirrhosis and acute upper gastrointestinal bleeding / 临床肝胆病杂志

ABSTRACT

ObjectiveTo 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). MethodsA 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. ResultsCompared 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). ConclusionPALBI 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.