Publication:

A comparative study of albumin bilirubin score, with meld for predicting the in-hospital mortality in cirrhotic patients complicated with upper gastrointestinal bleeding in a tertiary care hospital

Background Chronic liver disease (CLD) encompasses a spectrum of injury from simple steatosis to frank cirrhosis which is evaluated by many scoring systems. Aim of the study was to evaluate the discriminative abilities of model for end-stage liver disease (MELD) score and albumin-bilirubin (ALBI) score in predicting the in-hospital mortality in cirrhotic patients complicated with upper gastrointestinal bleeding.

Methods Data of patients with liver cirrhosis secondary to ethanol, hepatitis B and hepatitis C and cryptogenic liver cirrhosis, with upper gastrointestinal bleed was prospectively reviewed from admission to date of discharge. MELD and ALBI score, calculated for the patient from ROC curves were analysed.

Results Our study was conducted on 149 patients. Age distribution was between 18-80 years with mean age of patients being 44.7±12.37 years, male to female sex ratio 127:22, with mortality calculated at 23.5%. The MELD score demonstrated a high predictive accuracy with an area under ROC curve of 0.953, with a 95% confidence interval ranging from 0.903 to 1.000. In contrast, ALBI score showed a lower predictive accuracy with an area under the ROC curve (AUROC) of 0.672 and 95% confidence interval ranging from 0.577 to 0.766.

Conclusions The prognostic performance of two scores was comparable but MELD score was found to have a better prognostic significance than ALBI score.