Pasta A, Calabrese F, Plaz Torres MC, Bodini G, Furnari M, Savarino EV, Savarino V, Giannini EG, Marabotto E. Albumin-bilirubin score in non-malignant liver diseases should be properly validated. World J Gastroenterol 2023; 29(46): 6089-6091 [PMID: 38130741 DOI: 10.3748/wjg.v29.i46.6089]
Corresponding Author of This Article
Elisa Marabotto, MD, PhD, Academic Research, Doctor, Professor, Researcher, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS‐Ospedale Policlinico San Martino, Viale Benedetto XV, 6, Genoa 16132, Italy. elisa.marabotto@unige.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 14, 2023; 29(46): 6089-6091 Published online Dec 14, 2023. doi: 10.3748/wjg.v29.i46.6089
Albumin-bilirubin score in non-malignant liver diseases should be properly validated
Andrea Pasta, Francesco Calabrese, Maria Corina Plaz Torres, Giorgia Bodini, Manuele Furnari, Edoardo Vincenzo Savarino, Vincenzo Savarino, Edoardo Giovanni Giannini, Elisa Marabotto
Andrea Pasta, Francesco Calabrese, Maria Corina Plaz Torres, Giorgia Bodini, Manuele Furnari, Vincenzo Savarino, Edoardo Giovanni Giannini, Elisa Marabotto, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS‐Ospedale Policlinico San Martino, Genoa 16132, Italy
Edoardo Vincenzo Savarino, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua 35128, Italy
Co-first authors: Andrea Pasta and Francesco Calabrese.
Author contributions: Pasta A and Calabrese F contributed equally to the manuscript; Pasta A and Calabrese F designed and performed research; Pasta A and Calabrese F wrote the letter; Plaz Torres MC, Bodini G, Furnari M, Savarino V, Giannini EG, Savarino EV and Marabotto E revised the letter.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Elisa Marabotto, MD, PhD, Academic Research, Doctor, Professor, Researcher, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS‐Ospedale Policlinico San Martino, Viale Benedetto XV, 6, Genoa 16132, Italy. elisa.marabotto@unige.it
Received: September 20, 2023 Peer-review started: September 20, 2023 First decision: October 12, 2023 Revised: October 25, 2023 Accepted: November 17, 2023 Article in press: November 17, 2023 Published online: December 14, 2023
Abstract
The albumin-bilirubin (ALBI) score to assess the risk of decompensation in patients with initially compensated cirrhosis may improve their prognostic evaluation. This letter critically evaluates the research, which utilizes the ALBI score to forecast decompensation in cirrhosis patients over a three-year period. This score was initially developed to assess liver function in hepatocellular carcinoma, its prognostic utility for non-malignant liver diseases has now been explored, recognizing decompensation as a pivotal event that significantly affects patient’s survival. Some concerns regarding the methodology of this research may be raised, particularly the exclusive use of radiological diagnosis, potentially including patients without definite cirrhosis and thus skewing the decompensation risk assessment. The reported predominance of variceal bleeding as a decompensating event conflicts with established literature, that often reports ascites as the initial decompensation manifestation. The letter highlights the absence of details on esophageal varices and their management, which could introduce bias in evaluating the ALBI score's predictive power. Furthermore, the letter points out the small sample size of patients with high-risk ALBI grades, potentially compromising the score's validity in this context. We suggest prospective future research to investigate the dynamic changes in the ALBI score over time to reinforce the validity of the ALBI score as a predictor of decompensation in non-malignant liver disease.
Core Tip: The albumin-bilirubin (ALBI) score was initially proposed to evaluate liver function in patients with hepatocellular carcinoma. It proposed to validate the ALBI score to assess the risk of decompensation in patients with compensated cirrhosis. We provide a comment to highlight the preliminary nature of the evidence reported by the authors. Further studies are needed to validate the ALBI score to predict decompensation in patients with cirrhosis.
