ALBI score outperforms MELD XI for liver dysfunction assessment in acute heart failure

The albumin-bilirubin (ALBI) score may hold value as a marker for liver dysfunction in patients with acute heart failure (AHF), a recent study reports.

“[T]he ALBI score exceeds the MELD XI* score in prognostic predictive ability and shows additive prognostic value on top of that for pre-existing risk factors. Even though the pathophysiological background should be evaluated in future studies, the ALBI score may be a promising liver dysfunction score” in AHF patients, researchers said.

In the 1,190 participating AHF patients, the mean MELD XI and ALBI scores were 13.4±4.8 and –2.25±0.48, respectively. A weak but nevertheless statistically significant interaction was found between the two scores (r, 0.14; p<0.001).

Pearson’s correlation analysis showed that both MELD XI and ALBI scores were significantly correlated with liver function parameters—aspartate transaminase, alanine transaminase, and total bilirubin—though the magnitudes of interaction were all weak. When grouped according to tertiles, both scores also correlated with greater all-cause mortality within 1 year of admission, according to Kaplan-Meier curves.

Notably, only ALBI shared a significant relationship with a simple fluid overload (SFO) score, such that higher ALBI tertiles saw increasing SFO scores (p_trend<0.001).

Similarly, in the adjusted Cox regression model, only ALBI score was correlated with a higher 1-year mortality risk, using both categorical and continuous measurements. Receiver operating characteristic curve analysis likewise saw that ALBI had a better prognostic value than MELD XI.

* Model of end-stage liver disease excluding prothrombin time