Department of Urology Anhui Provincal Children's Hospital, Hefei, China.
Mediators Inflamm. 2024 Jul 18;2024:1412709. doi: 10.1155/2024/1412709. eCollection 2024.
The albumin-bilirubin (ALBI) grade has surfaced as a viable substitute for assessing liver functional reserve in individuals afflicted with hepatocellular carcinoma (HCC). ALBI grade also demonstrates the capacity to stratify distinct patient subcohorts bearing disparate prognostic implications in not only HCC but also other inflammatory diseases like acute pancreatitis. However, the association between ALBI grade and clinical outcomes of acute kidney injury (AKI) remains mysterious.
The dataset was sourced from the Multiparameter Intelligent Monitoring in Intensive Care Database IV (MIMIC-IV) version 2.0. ALBI grade was calculated in a nomogram utilizing albumin and bilirubin. In order to ascertain the connection between ALBI grades and clinical outcomes of patients with AKI, Cox proportional hazards regression analysis was employed with in-hospital, 30- and 90-day mortality as end points, respectively. The Kaplan-Meier (K-M) curve was employed to gauge the cumulative incidence of mortality based on various ALBI grades. To explore potential nonlinear relationships, the Restricted Cubic Spline (RCS) approach was adopted. Furthermore, a subgroup analysis was conducted to validate the durability of the correlation between ALBI grade and in-hospital mortality. Furthermore, equilibrium of confounding variables was also achieved through the application of propensity score matching (PSM).
The study encompassed a total of 12,518 patients (ALBI grade 1 : 2878, grade 2 : 6708, and grade 3 : 2932). Patients with heightened ALBI grades displayed a significant correlation with increased mortality in both univariate and various multivariate Cox regression models. RCS depicted a predominantly linear relationship. The robustness of the correlation was also affirmed across multifarious subpopulations through subgroup analysis. The association still remains after PSM.
Elevated ALBI grade was associated with worse clinical outcomes of critically ill patients with AKI.
白蛋白-胆红素（ALBI）分级已成为评估肝细胞癌（HCC）患者肝储备功能的可行替代方法。ALBI 分级还能够对不同的患者亚组进行分层，这些患者亚组在 HCC 以及其他炎症性疾病（如急性胰腺炎）中具有不同的预后意义。然而，ALBI 分级与急性肾损伤（AKI）的临床结局之间的关系仍然是个谜。
数据集来源于 Multiparameter Intelligent Monitoring in Intensive Care Database IV（MIMIC-IV）版本 2.0。使用白蛋白和胆红素在列线图中计算 ALBI 分级。为了确定 ALBI 分级与 AKI 患者临床结局之间的关系，分别使用 Cox 比例风险回归分析作为住院期间、30 天和 90 天死亡率的终点。使用 Kaplan-Meier（K-M）曲线根据不同的 ALBI 分级评估死亡率的累积发生率。为了探索潜在的非线性关系，采用了限制性立方样条（RCS）方法。此外，还进行了亚组分析以验证 ALBI 分级与住院死亡率之间相关性的稳健性。此外，还通过应用倾向评分匹配（PSM）实现了混杂变量的平衡。
该研究共纳入了 12518 名患者（ALBI 分级 1：2878 例，分级 2：6708 例，分级 3：2932 例）。在单变量和各种多变量 Cox 回归模型中，ALBI 分级较高的患者与死亡率增加呈显著相关。RCS 描绘了一种主要的线性关系。通过亚组分析，在多种亚人群中也证实了这种相关性的稳健性。在 PSM 后，这种关联仍然存在。
升高的 ALBI 分级与危重症 AKI 患者的临床结局较差相关。
