Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding
Abstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-03-01
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| Series: | Egyptian Liver Journal |
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| Online Access: | https://doi.org/10.1186/s43066-021-00088-6 |
| _version_ | 1831668824674402304 |
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| author | Rehab Elsayed Elsafty Abdallah Ahmed Elsawy Ahmed Fawzy Selim Atef Mohamed Taha |
| author_facet | Rehab Elsayed Elsafty Abdallah Ahmed Elsawy Ahmed Fawzy Selim Atef Mohamed Taha |
| author_sort | Rehab Elsayed Elsafty |
| collection | DOAJ |
| description | Abstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding, in comparison to Child-Pugh and MELD scores. This prospective cohort study was conducted on 250 cirrhotic patients who were consecutively presented by acute variceal bleeding in the period from January to December 2020 at Tanta university emergency hospital. Albumin-bilirubin, Child-Pugh, and MELD scores were measured at admission, and then all patients were followed up for 4 weeks after endoscopic bleeding control for possible occurrence of hepatic encephalopathy Results Albumin-bilirubin, Child-Pugh, and MELD scores had significant performances in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding; in this regard, albumin-bilirubin score had the highest accuracy (AUC 0.858, CI 0.802-0.914, sig 0.000) followed by Child-Pugh score (AUC 0.654, CI 0.574–0.735, sig 0.001) and then MELD score (AUC 0.602, CI 0.519–0.686, sig 0.031). The cumulative incidence of hepatic encephalopathy in cirrhotic patients with albumin-bilirubin grade 3 was found to be significantly more than that present in albumin-bilirubin grade 2; most of these hepatic encephalopathy cases occurred in the first 2 weeks of follow-up period. Conclusions Albumin-bilirubin score has a significant performance in risk prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding better than Child-Pugh and MELD scores. Albumin-bilirubin grades could be used as a risk stratifying tool to triage cirrhotic patients who will benefit from early discharge after bleeding control and those patients who will benefit from prophylactic measures for hepatic encephalopathy. |
| first_indexed | 2024-12-19T22:47:18Z |
| format | Article |
| id | doaj.art-5db0147f36634a6e8f0d673e3ba1e491 |
| institution | Directory Open Access Journal |
| issn | 2090-6226 |
| language | English |
| last_indexed | 2024-12-19T22:47:18Z |
| publishDate | 2021-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Liver Journal |
| spelling | doaj.art-5db0147f36634a6e8f0d673e3ba1e4912022-12-21T20:02:55ZengSpringerOpenEgyptian Liver Journal2090-62262021-03-011111710.1186/s43066-021-00088-6Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleedingRehab Elsayed Elsafty0Abdallah Ahmed Elsawy1Ahmed Fawzy Selim2Atef Mohamed Taha3Department of Internal Medicine, Faculty of Medicine, Tanta UniversityDepartment of Internal Medicine, Faculty of Medicine, Tanta UniversityDepartment of Internal Medicine, Faculty of Medicine, Tanta UniversityDepartment of Internal Medicine, Faculty of Medicine, Tanta UniversityAbstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding, in comparison to Child-Pugh and MELD scores. This prospective cohort study was conducted on 250 cirrhotic patients who were consecutively presented by acute variceal bleeding in the period from January to December 2020 at Tanta university emergency hospital. Albumin-bilirubin, Child-Pugh, and MELD scores were measured at admission, and then all patients were followed up for 4 weeks after endoscopic bleeding control for possible occurrence of hepatic encephalopathy Results Albumin-bilirubin, Child-Pugh, and MELD scores had significant performances in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding; in this regard, albumin-bilirubin score had the highest accuracy (AUC 0.858, CI 0.802-0.914, sig 0.000) followed by Child-Pugh score (AUC 0.654, CI 0.574–0.735, sig 0.001) and then MELD score (AUC 0.602, CI 0.519–0.686, sig 0.031). The cumulative incidence of hepatic encephalopathy in cirrhotic patients with albumin-bilirubin grade 3 was found to be significantly more than that present in albumin-bilirubin grade 2; most of these hepatic encephalopathy cases occurred in the first 2 weeks of follow-up period. Conclusions Albumin-bilirubin score has a significant performance in risk prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding better than Child-Pugh and MELD scores. Albumin-bilirubin grades could be used as a risk stratifying tool to triage cirrhotic patients who will benefit from early discharge after bleeding control and those patients who will benefit from prophylactic measures for hepatic encephalopathy.https://doi.org/10.1186/s43066-021-00088-6Albumin-bilirubin scorePredictionHepatic encephalopathyVariceal bleedingCirrhosis |
| spellingShingle | Rehab Elsayed Elsafty Abdallah Ahmed Elsawy Ahmed Fawzy Selim Atef Mohamed Taha Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding Egyptian Liver Journal Albumin-bilirubin score Prediction Hepatic encephalopathy Variceal bleeding Cirrhosis |
| title | Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding |
| title_full | Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding |
| title_fullStr | Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding |
| title_full_unstemmed | Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding |
| title_short | Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding |
| title_sort | performance of albumin bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding |
| topic | Albumin-bilirubin score Prediction Hepatic encephalopathy Variceal bleeding Cirrhosis |
| url | https://doi.org/10.1186/s43066-021-00088-6 |
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