Gao Xiaopo, Li Cheng, Wang Yurou, Cu Yun, Zheng Yingfang, Dai Hongkai, Yuan Xinrun, Luo Jinlong, Zhan Chengye
Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
BMC Cardiovasc Disord. 2025 Apr 23;25(1):307. doi: 10.1186/s12872-025-04760-2.
Heart failure (HF) is a chronic progressive syndrome caused by a variety of cardiovascular diseases and is associated with high morbidity, mortality, and healthcare burden. Forecasting the prognosis of HF patients at an early stage is important. Therefore, our objective was to explore the relationship between HF patients' prognosis and the albumin-bilirubin (ALBI) grade.
Data for the study were obtained from the MIMIC database. Patients with ALBI grade 1 were matched to patients with ALBI grades 2 and 3 using propensity score matching (PSM). Post-matching analyses were performed using Cox proportional hazards models, Kaplan-Meier survival analysis, restricted cubic splines (RCS), and subgroup analyses.
RCS analyses revealed a nonlinear relationship between ALBI grade and 30-, 90-, and 360-day mortality in patients with HF, with a threshold value identified at -1.92. When ALBI scores were below - 1.92, the risk of mortality in HF patients remained relatively stable. In contrast, as ALBI scores approached and exceeded - 1.92, the mortality risk increased rapidly. Before PSM, both ALBI grades 2 and 3 were independent predictors of mortality in patients with HF; however, after PSM, ALBI grade 2 was not statistically associated with patient mortality. This result was supported by Kaplan-Meier (K-M) analysis.
心力衰竭（HF）是一种由多种心血管疾病引起的慢性进行性综合征，与高发病率、死亡率和医疗负担相关。早期预测HF患者的预后很重要。因此，我们的目的是探讨HF患者预后与白蛋白-胆红素（ALBI）分级之间的关系。
研究数据来自MIMIC数据库。使用倾向评分匹配（PSM）将ALBI 1级患者与ALBI 2级和3级患者进行匹配。匹配后使用Cox比例风险模型、Kaplan-Meier生存分析、限制性立方样条（RCS）和亚组分析进行分析。
RCS分析显示，HF患者的ALBI分级与30天、90天和360天死亡率之间存在非线性关系，阈值为-1.92。当ALBI评分低于-1.92时，HF患者的死亡风险相对稳定。相比之下，随着ALBI评分接近并超过-1.92，死亡风险迅速增加。在PSM之前，ALBI 2级和3级都是HF患者死亡率的独立预测因素；然而，在PSM之后，ALBI 2级与患者死亡率无统计学关联。这一结果得到了Kaplan-Meier（K-M）分析的支持。
