GIÁ TRỊ CỦA THANG ĐIỂM ALBI-FIB4 Ở BỆNH NHÂN XƠ GAN

Abstract

Objectives: To investigate the changes and prognostic value of the ALBI-FIB4 score in predicting complications in patients with liver cirrhosis. Subjects and Methods: A cross-sectional study was conducted on 289 patients diagnosed with cirrhosis at Hanoi Medical University Hospital from August 2024 to April 2025. The diagnosis of cirrhosis was based on two syndromes: hepatocellular failure and portal hypertension; decompensated cirrhosis was defined according to the Baveno VII criteria, and ascites was classified according to the 2007 International Ascites Club guidelines. The study investigated changes in the ALBI-FIB4 score and determined the cutoff value, sensitivity, specificity, and area under the ROC curve in evaluating the prognosis of decompensation and certain complications in cirrhotic patients. Results: The average age of patients in the study was 56.93 ± 10.75 years. Males accounted for 83.7%. The most common cause of cirrhosis was alcohol, at 62.6%; followed by hepatitis B virus at 40%, and hepatitis C virus at 5.9%. The average ALBI-FIB4 score in the study was -1.685 (-2.965 to -0.439), with the compensated cirrhosis group having a score of -2.966 (-3.597 to -2.242), which was lower than the decompensated cirrhosis group, which had a score of -0.752 (-1.676 to 0.130). ALBI-FIB4 is a reliable factor for predicting decompensated cirrhosis, with an odds ratio (OR) of 3.023 and a 95% confidence interval (CI) of 2.326 to 3.929. ALBI-FIB4 showed a strong positive correlation with cirrhosis progression (r = 0.636), with a 95% CI of 0.561 to 0.709. The cutoff point for predicting decompensation using ALBI-FIB4 was -2.217. The area under the curve (AUC) was 0.87, with a sensitivity of 87.7% and specificity of 76.2%. ALBI-FIB4 had high value in predicting ascitic complications, with an AUC of 0.831 at the cutoff point of -1.609, showing a sensitivity of 78.4% and specificity of 79.9%. For predicting gastrointestinal bleeding complications, ALBI-FIB4 had an AUC of 0.646, with a cutoff point of -2.197, showing a sensitivity of 80.8% and specificity of 48.6%. For hepatic encephalopathy, ALBI-FIB4 had predictive value with an AUC of 0.793, with a cutoff point of -1.510, showing 100% sensitivity and 59.6% specificity. Conclusion: ALBI-FIB4 has predictive value for the risk of decompensation and ascites complications in patients with cirrhosis.