Comparison of ALBI, PALBI, MELD and Child-Pugh scores in chronic liver disease: evidence from Bangladesh

Background: Accurate assessment of hepatic reserve is essential for prognosis in chronic liver disease (CLD). This study aimed to evaluate the correlation of ALBI and PALBI scores with MELD and Child-Turcotte-Pugh (CTP) scores and compare their predictive value in Bangladeshi patients with CLD of mixed etiologies. Methods: A cross-sectional study was conducted among 105 patients with established CLD. Clinical and laboratory data were collected to calculate ALBI, PALBI, MELD, and CTP scores. Correlations were assessed using Spearman’s rank test, while hierarchical linear regression evaluated the independent predictive contribution of ALBI and PALBI. Results: ALBI and PALBI showed significant positive correlations with MELD (ρ=0.539 and 0.625, respectively; p<0.001) and CTP (ρ=0.721 and 0.679, respectively; p<0.001). Age was not significantly associated with MELD or CTP scores. PALBI showed a stronger predictive contribution for MELD (ΔR2=0.085, p<0.001), whereas ALBI demonstrated greater unique contribution to CTP (ΔR2=0.054, p=0.001). Conclusions: ALBI and PALBI are simple, objective, and economical indices that correlate well with conventional liver severity scores. PALBI better reflects MELD-related systemic components, while ALBI more closely represents hepatic functional reserve.