Value of Albumin Bilirubin and Platelet Albumin Bilirubin scores in predicting the outcome of portal hypertension-related acute upper gastrointestinal bleeding in cirrhotic patients.

Background: Portal hypertension-related acute upper gastrointestinal bleeding (AUGIB) in cirrhosis carries high morbidity and mortality, requiring objective early risk-stratification tools. The Albumin-Bilirubin (ALBI) and Platelet-Albumin-Bilirubin (PALBI) scores have been proposed as prognostic markers. Objective: To assess the predictive value of ALBI and PALBI scores in cirrhotic patients presenting with AUGIB. Methods: A prospective cohort of 100 cirrhotic patients admitted with AUGIB to Ain Shams University Hospitals was evaluated. ALBI and PALBI scores were calculated at admission, and patients were followed for length of stay, hepatic encephalopathy, transfusion requirements, ICU admission, and mortality, however, statistically insignificant in terms of rebleeding incidence. Results: Patients had a mean age of 57.5 years; 63% were male. Higher ALBI and PALBI grades were associated with longer hospitalization, more encephalopathy, increased transfusion needs, and higher ICU admission rates. Mortality occurred only in ALBI 3 and PALBI 3 groups. ALBI (AUROC 0.81) showed stronger predictive accuracy for mortality, while PALBI (AUROC 0.66) was more sensitive for encephalopathy. Conclusion: ALBI and PALBI scores effectively predict adverse outcomes in cirrhotic AUGIB. ALBI offers superior mortality prediction, whereas PALBI better identifies patients at risk for encephalopathy.