Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
BMJ Open. 2022 Jan 4;12(1):e049325. doi: 10.1136/bmjopen-2021-049325.
Liver dysfunction is prevalent in patients with heart failure (HF) and can lead to poor prognosis. The albumin-bilirubin (ALBI) score is considered as an effective and convenient scoring system for assessing liver function. We analysed the correlation between ALBI and in-hospital mortality in patients with HF.
A retrospective cohort study.
A total of 9749 patients with HF (from January 2013 to December 2018) was enrolled and retrospectively analysed.
The main outcome is in-hospital mortality.
ALBI score was calculated using the formula (log bilirubin [umol/L] * 0.66) + (albumin [g/L] * -0.085), and analysed as a continuous variable as well as according to three categories. Following adjustment for multivariate analysis, patients which occurred in-hospital death was remarkably elevated in tertile 3 group (ALBI ≥2.27) (OR 1.671, 95% CI 1.228 to 2.274, p=0.001), relative to the other two groups (tertile 1: ≤2.59; tertile 2: -2.59 to -2.27). Considering ALBI score as a continuous variable, the in-hospital mortality among patients with HF increased by 8.2% for every 0.1-point increase in ALBI score (OR 1.082; 95% CI 1.052 to 1.114; p<0.001). The ALBI score for predicting in-hospital mortality under C-statistic was 0.650 (95% CI 0.641 to 0.660, p<0.001) and the cut-off value of ALBI score was -2.32 with a specificity of 0.630 and a sensitivity of 0.632. Moreover, ALBI score can enhance the predictive potential of NT-pro-BNP (NT-pro-BNP +ALBI vs NT-pro-BNP: C-statistic: z=1.990, p=0.0467; net reclassification improvement=0.4012, p<0.001; integrated discrimination improvement=0.0082, p<0.001).
In patients with HF, the ALBI score was an independent prognosticator of in-hospital mortality. The predictive significance of NT-proBNP +ALBI score was superior to NT-proBNP, and ALBI score can enhance the predictive potential of NT-proBNP.
肝功能障碍在心力衰竭（HF）患者中较为常见，可导致预后不良。白蛋白-胆红素（ALBI）评分被认为是评估肝功能的一种有效且便捷的评分系统。我们分析了 ALBI 与 HF 患者住院死亡率之间的相关性。
回顾性队列研究。
共纳入 9749 例 HF 患者（2013 年 1 月至 2018 年 12 月），并进行回顾性分析。
主要观察指标为住院死亡率。
ALBI 评分采用公式（log 胆红素[umol/L] * 0.66）+（白蛋白[g/L] * -0.085）计算，并作为连续变量和三个类别进行分析。经多变量分析调整后，第 3 组（ALBI≥2.27）发生院内死亡的患者显著增加（OR 1.671，95%CI 1.228 至 2.274，p=0.001），与其他两组（第 1 组：≤2.59；第 2 组：-2.59 至-2.27）相比。考虑到 ALBI 评分作为连续变量，HF 患者的 ALBI 评分每增加 0.1 分，其住院死亡率增加 8.2%（OR 1.082；95%CI 1.052 至 1.114；p<0.001）。C 统计量下 ALBI 评分预测住院死亡率的截断值为-2.32，特异性为 0.630，灵敏度为 0.632。此外，ALBI 评分可提高 NT-pro-BNP 的预测能力（NT-pro-BNP+ALBI 与 NT-pro-BNP：C 统计量：z=1.990，p=0.0467；净重新分类改善=0.4012，p<0.001；综合鉴别改善=0.0082，p<0.001）。
在 HF 患者中，ALBI 评分是住院死亡率的独立预后指标。NT-proBNP+ALBI 评分的预测意义优于 NT-proBNP，ALBI 评分可提高 NT-proBNP 的预测能力。
