Albumin-bilirubin score as a predictor of all-cause mortality in patients with hepatitis B virus infection: An analysis of National Health and Nutrition Examination Survey (NHANES) 1999–2018

Abstract

ObjectivesThe Albumin-Bilirubin (ALBI) score has been widely used to assess the prognosis in patients with cirrhosis and hepatocellular carcinoma. This study aimed to analyze the relationship between ALBI score and all-cause mortality in patients with hepatitis B virus (HBV) infection in general. MethodsPatients aged ≥ 18 years with previous or current HBV infection from the National Health and Nutrition Examination Survey (NHANES) in the United States between 1999 and 2018 were enrolled in this retrospective cohort study. Weight univariate and multivariate Cox regression models were used to assess the relationship between ALBI score and all-cause mortality. The area under the receiver operating characteristic curve (AUC) was utilized to assess the predictive effect of ALBI score for all-cause mortality. ResultsA total of 3,666 patients were included, of whom 925 (23.53 %) patients died. Compared with ALBI score ≤ -2.6, HBV-infected patients with ALBI score > -2.6 [hazard ratio (HR) = 1.75; 95 % confidence interval (CI): 1.43–2.14] were corrected with a higher all-cause mortality risk after adjusting for confounders. Stratified analyses showed that higher ALBI score was related to a higher risk of all-cause mortality in different patients with HBV infection (All P < 0.05). Furthermore, the ALBI score had good predictive ability for 1-year (AUC = 0.816, 95 %CI: 0.754–0.878), 3-year (AUC = 0.808, 95 %CI: 0.775–0.841), 5-year (AUC = 0.809, 95 %CI: 0.783–0.835), and 10-year (AUC = 0.806, 95 %CI: 0.784–0.827) all-cause mortality. ConclusionHigher ALBI score was related to a higher risk of all-cause mortality in patients with HBV infection, and the ALBI score showed a good predictive effect for short- and long-term all-cause mortality.