Albuminâ??bilirubin (ALBI) grade is defined using the ALBI score, which is calculated based\non total serum bilirubin and albumin. This study aimed to evaluate the diagnostic ability of the\nALBI score for determining hepatic fibrosis stage and transplant-free survival in primary biliary\ncholangitis (PBC) patients. A total of 181 Japanese patients with biopsy-proven or serologically\ndiagnosed PBC were enrolled. The pathological stage was assessed using the Scheuer classification.\nThe ALBI score differentiated fibrosis in stage 4 from that of 3 in the biopsy-proven cohort (p < 0.05).\nWith an ALBI score cut-off value of -1.679, the sensitivity and specificity were 100% and 91.1%,\nrespectively, with a likelihood ratio of 12.3 to differentiate stage 4 from stages 1â??3. The ALBI score at\nthe beginning of ursodeoxycholic acid (UDCA) prescription correlated with the two prognostic scores\ncalculated after 1-year UDCA treatment. Kaplanâ??Meier analysis showed that the baseline ALBI score\ndifferentiated liver transplant-free survival (p < 0.05). The ALBI score presented a greater hazard\nratio for transplant-free survival than aspartate aminotransferase-to-platelet ratio index (APRI) in\nCox proportional hazard model. In conclusion, ALBI score indicates pathological stage in Japanese\nPBC patients and scores before UDCA prescription predict better liver transplant-free survival,\nwhich correlated well with the two major prognostic scores. The prognosis-predicting ability of the\nALBI score might surpass that of APRI.
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