Effectiveness of albumin-bilirubin score in predicting mortality in intensive care patients

Aim: The Albumin-Bilirubin (ALBI) score, originally developed to assess liver function in patients with hepatocellular carcinoma, has recently gained attention as a prognostic marker in critically ill patients. This study aimed to evaluate the effectiveness of the ALBI score in predicting mortality among intensive care unit (ICU) patients. Material and Methods: This retrospective study included 157 adult patients admitted to the ICU diverse clinical conditions, including sepsis, respiratory failure, trauma, acute neurological events, and post-cardiac arrest, between November 2023 and November 2024. Clinical data, laboratory parameters, ALBI, SOFA, and APACHE II scores were assessed at ICU admission. The ALBI score is calculated as follows: (log10 bilirubin [μmol/L] × 0.66) + (albumin [g/L] × −0.085). Results: Among the study participants (mean age: 71.7 ± 18.6 years; 55.4% male), 42.7% had diabetes mellitus, 21.7% chronic kidney disease (CKD), 38.9% chronic obstructive pulmonary disease, 73.9% cardiovascular disease, and 19.7% malignancies. The overall mortality rate was 42.7%. Multivariable Cox regression analysis revealed that CKD (HR: 1.90; 95% CI: 1.07–3.39; p = 0.029), higher ALBI scores (HR: 1.65; 95% CI: 1.03–2.65; p = 0.038) and higher APACHE II scores (HR: 1.04; 95% CI: 1.00–1.08; p = 0.031) were independent predictors of mortality. Conclusion: The ALBI score is an independent predictor of mortality among critically ill patients with heterogeneous clinical conditions in general ICU settings. By integrating hepatic dysfunction, nutritional status, and systemic inflammation, ALBI complements traditional prognostic tools and may enhance clinical decision-making and risk stratification.