Comparison of ALBI, PALBI, MELD and Child-Pugh scores in chronic liver disease: evidence from Bangladesh

Authors

  • A. B. M. Shakil Gani Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Uzzal Kanti Debnath Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • M. Sabbir Hossain Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • M. Nur Islam Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Zannatul Habiba Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Ankita Banik Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Rebeka Sultana Mousumi Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Sourav Kumar Saha 1Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Ihteshamul Hoq Dew Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Forhad Hossain Md Shahed Department of Hepatology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Tasnim Mahmud Department of Public Health, North South University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20264048

Keywords:

ALBI, Child-Pugh, Hepatic reserve, MELD, PALBI

Abstract

Background: Accurate assessment of hepatic reserve is essential for prognosis in chronic liver disease (CLD). This study aimed to evaluate the correlation of ALBI and PALBI scores with MELD and Child-Turcotte-Pugh (CTP) scores and compare their predictive value in Bangladeshi patients with CLD of mixed etiologies.

Methods: A cross-sectional study was conducted among 105 patients with established CLD. Clinical and laboratory data were collected to calculate ALBI, PALBI, MELD, and CTP scores. Correlations were assessed using Spearman’s rank test, while hierarchical linear regression evaluated the independent predictive contribution of ALBI and PALBI.

Results: ALBI and PALBI showed significant positive correlations with MELD (ρ=0.539 and 0.625, respectively; p<0.001) and CTP (ρ=0.721 and 0.679, respectively; p<0.001). Age was not significantly associated with MELD or CTP scores. PALBI showed a stronger predictive contribution for MELD (ΔR2=0.085, p<0.001), whereas ALBI demonstrated greater unique contribution to CTP (ΔR2=0.054, p=0.001).

Conclusions: ALBI and PALBI are simple, objective, and economical indices that correlate well with conventional liver severity scores. PALBI better reflects MELD-related systemic components, while ALBI more closely represents hepatic functional reserve.

 

References

Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019;70(1):151-71.

Sarin SK, Kumar M, Eslam M, George J, Al Mahtab M, Akbar SM, et al. Liver diseases in the Asia-Pacific region: a lancet gastroenterology and hepatology commission. Lancet Gastroenterol Hepatol. 2020;5(2):167-228.

Al Mahtab M, Chaudhury M, Uddin MH, Alam SM, Rahim MA, Alam MA, et al. Cost assessment of hepatitis B virus-related hepatitis in Bangladesh. Euroas J Hepato-Gastroenterol. 2016;6(2):163.

Lavanchy D. Chronic viral hepatitis as a public health issue in the world. Best Pract Res Clin Gastroenterol. 2008;22(6):991-1008.

Pugh RN, Murray‐Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646-9.

Cholongitas E, Papatheodoridis GV, Vangeli M, Terreni N, Patch D, Burroughs AK. Systematic review: the model for end‐stage liver disease-should it replace Child‐Pugh’s classification for assessing prognosis in cirrhosis? Aliment Pharmacol Therap. 2005;22(11‐12):1079-89.

Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, et al. A model to predict survival in patients with end‐stage liver disease. Hepatology. 2001;33(2):464-70.

Angermayr B, Cejna M, Karnel F, Gschwantler M, Koenig F, Pidlich J, et al. Child-Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt. Gut. 2003;52(6):879-85.

Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach- the ALBI grade. J Clin Oncol. 2015 0;33(6):550-8.

Hiraoka A, Kumada T, Michitaka K, Toyoda H, Tada T, Ueki H, et al. Usefulness of albumin-bilirubin grade for evaluation of prognosis of 2584 Japanese patients with hepatocellular carcinoma. J Gastroenterol Hepatol. 2016;31(5):1031-6.

Singh V, Rai N, Singh B, Vijayvergiya R, Sharma N, Bhalla A, et al. Ascites, renal dysfunction, and hepatorenal syndrome. Hepatology. 2015;62(1):93A-207A.

Peng Y, Qi X, Guo X. Child-Pugh versus MELD score for the assessment of prognosis in liver cirrhosis: a systematic review and meta-analysis of observational studies. Medicine. 2016;95(8):e2877.

Pilossoff V. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010): the Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC). Eur Heart J. 2010.

Wong GL, Chan HL, Wong CK, Leung C, Chan CY, Ho PP, et al. Liver stiffness-based optimization of hepatocellular carcinoma risk score in patients with chronic hepatitis B. J Hepatol. 2014;60(2):339-45.

Cho CW, You MW, Oh CH, Lee CK, Moon SK. Long-term disease course of Crohn’s disease: changes in disease location, phenotype, activities, and predictive factors. Gut Liver. 2021;16(2):157.

Hiraoka A, Kumada T, Kudo M, Hirooka M, Tsuji K, Itobayashi E, et al. Albumin-bilirubin (ALBI) grade as part of the evidence-based clinical practice guideline for HCC of the Japan Society of Hepatology: a comparison with the liver damage and Child-Pugh classifications. Liver Cancer. 2017;6(3):204-15.

Huang CY, Wu SC, Liu HT, Su WT, Hsu SY, Li C, et al. Evaluation of the Geriatric Trauma Outcome Score (GTOS) as a Prognostic Tool in Intensive Care Unit Trauma Patients. Diagnostics. 2024;14:2146.

Toyoda H, Lai P, O’Beirne J, Chong CC, Berhane S, Reeves H, et al. Long-term impact of liver function on curative therapy for hepatocellular carcinoma: application of the ALBI grade. Br J Cancer. 2016;114(7):744-50.

Wang YY, Zhong JH, Su ZY, Huang JF, Lu SD, Xiang BD, et al. Albumin-bilirubin versus Child-Pugh score as a predictor of outcome after liver resection for hepatocellular carcinoma. J Br Surg. 2016;103(6):725-34.

Mahtab MA. Epidemiology of viral hepatitis and liver diseases in Bangladesh. Euroas J Hepato-Gastroenterol. 2015;5(1):26.

Kamath PS, Kim WR. The model for end‐stage liver disease (MELD). Hepatology. 2007;45(3):797-805.

Downloads

Published

2026-10-30

How to Cite

Gani, A. B. M. S., Debnath, U. K., Hossain, M. S., Islam, M. N., Habiba, Z., Banik, A., Mousumi, R. S., Saha, S. K., Dew, I. H., Shahed, F. H. M., & Mahmud, T. (2026). Comparison of ALBI, PALBI, MELD and Child-Pugh scores in chronic liver disease: evidence from Bangladesh. International Journal Of Community Medicine And Public Health, 13(11), 6302–6308. https://doi.org/10.18203/2394-6040.ijcmph20264048

Issue

Section

Original Research Articles