Abstract
Cirrhosis of liver is characterized by the replacement of normal liver tissue by scar tissue. The Child-Turcotte-Pugh (CTP) score is used to assess the prognosis of cirrhosis and included five factors: total bilirubin level, serum albumin, prothrombin time, ascites and hepatic encephalopathy. CTP score depends on clinical assessment which may result variation in scoring. Recently a new score is introduced, Albumin-Bilirubin (ALBI) score which may be done instead of CTP scoring in cirrhotic patient. This cross sectional study was conducted at the Department of Laboratory Medicine in collaboration with the Department of Hepatology, BSMMU, Dhaka, from March 2018 to February 2019. Blood samples were assayed from eighty one diagnosed cirrhotic patients. For all statistical analysis SPSS version 22 was used. The mean age of the study group was 46.1±16.0 years. 64.2% were male and 35.8% were female. Kappa (k) value was 0.759 between ALBI and CTP score. Pearson's correlation coefficient (r) test showed significant strong positive correlation between CTP score and ALBI score (r=+0.853, p<0.001). This study concluded that the ALBI score may be done alternative to the CTP score in cirrhotic patient because it’s simple, two parameters only, more evidence based and more objective.
Highlights
Cirrhosis is a diffuse process of fibrosis with nodule formation [1]
Cirrhosis is caused by viruses, alcohol, nonalcoholic steatohepatitis (NASH) and metabolic causes including autoimmune conditions [2]. 20-30% of chronic hepatitis B and 15-30% of chronic hepatitis C patients develop cirrhosis [3]
InBangladesh 8.5 million adults are infected with chronic hepatitis B virus (HBV) and 61.15% of cirrhosis is caused by HBV [4, 5]
Summary
Cirrhosis is a diffuse process of fibrosis with nodule formation [1]. Cirrhosis is caused by viruses, alcohol, nonalcoholic steatohepatitis (NASH) and metabolic causes including autoimmune conditions [2]. 20-30% of chronic hepatitis B and 15-30% of chronic hepatitis C patients develop cirrhosis [3]. Compared to CTP score, there are several advantages of (SIEMENS Dimension RxL Max, USA) in the Laboratory the Albumin-Bilirubin (ALBI) score in grading of liver Medicine Department, BSMMU, Dhaka. The clinical assessment of ascites bilirubin- 3-16 μmol/L, Prothrombin time- 10.5-13.5 and hepatic encephalopathy for the CTP score is difficult to seconds [16]. Another study support that sensitivity and specificity of ALBI score in liver cirrhosis patient with upper gastrointestinal bleeding is 92.86% and 64.01% respectively but in case of CTP score sensitivity and specificity is 57.14%. Albumin-Bilirubin score are simple, repeatable, less expensive, can be done even in peripheral laboratory, without the need for special tests This new score may be a better tool than CTP score in cirrhotic patients for early. Variables Serum albumin (g/dl) Serum bilirubin (mg/dl) Prothrombin Time (sec) INR
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