Association between albumin-bilirubin score and in-hospital mortality in patients with sepsis: Evidence from two large databases

Erya Gou, Qilin Yang, Jieru Chen, Tianyu Kong, Zhiwei Tang, Qirui Wen, Wenxing Huang, Guangqian Yang, Wenling Li, Deliang Wen, Zhenhui Zhang

Abstract:

Background: The Albumin-Bilirubin (ALBI) score, recommended for assessing the prognosis of
hepatocellular carcinoma patients, has garnered attention. The efficacy of ALBI score in fore-
casting the risk of death in sepsis patients remains limited. We designed two cohort studies to
assess the association between ALBI score and in-hospital mortality in patients with sepsis.
Methods: A retrospective analysis was conducted utilizing data from the Second Affiliated Hospital
of Guangzhou Medical University and the Medical Information Mart for Intensive Care IV(MIMIC-
IV). Patients diagnosed with sepsis were included in the analysis. The primary outcome was the
in-hospital mortality. Multivariate Cox regression analysis was conducted to assess the inde-
pendent association between the ALBI score and mortality, with adjustment for potential con-
founders. Subgroup analysis was conducted to assess the robustness of the findings.
Results: The Guangzhou Sepsis Cohort (GZSC) of the Second Affiliated Hospital of Guangzhou
Medical University comprised 2969 participants, while the MIMIC-IV database included 8841
participants. The ALBI score were categorized into < -2.60, 2.60~-1.39, and >-1.39. After
adjusting for confounders, a linear relationship was observed between ALBI score and mortality.
Patients with a high ALBI grade were associated with higher in-hospital mortality in both the
GZSC (HR: 1.52, 95%CI: 1.24–1.87, p < 0.001) and the MIMIC-IV database (HR: 1.57, 95%CI:
1.46–1.70, p < 0.001).
Conclusions: A high ALBI score is associated with higher in-hospital mortality among sepsis pa-
tients in ICU.