Prediction of outcomes of acute variceal hemorrhage in cirrhotic patients using platelet albumin bilirubin (PALBI) score.

Abstract

Objective: To determine the predictive ability of “platelet albumin bilirubin (PALBI)” scores in assessing outcomes among acute variceal hemorrhage (AVH) patients. Study Design: Cross-sectional study. Setting: Department of Gastroenterology, Liaquat National Hospital. Period: September 2022 to September 2023. Methods: Cirrhotic patients with upper gastrointestinal bleed of either gender of age at least 18 years were included. Patients with malignancies and unwilling to participate were excluded. Patients were enlisted with their written informed consent. Data was analyzed using IBM-SPSS version 26. Results: Total 300 patients were enrolled into the study with mean age of 59.9 ± 10.4 years and majority were males (73.7%). According to endoscopic findings, small, medium and large esophageal varices (EV) were seen in 9%, 28% and 63% patients respectively. Rebleeding was seen in 27.7%. On multivariable model, none of the score including “Child-Turcotte-Pugh (CTP)” score, “Model of End-stage Liver Disease (MELD)” score, “albumin-bilirubin (ALBI)” score and PALBI score were found to be associated with rebleeding. During the study in-hospital mortalities were seen in 10.3% cases. In multivariable regression analysis, when adjusted for confounders, prediction score MELD and PALBI were found to be linked with in-hospital mortality. Conclusion: The present study found that PALBI predicting in-hospital mortality even after adjusting other confounders. However, PALBI was not a promising marker for prediction of re-bleeding.