Objective To investigate the predictive value of the albumin-bilirubin(ALBI)score for short-term all-cause mortality in patients with acute decompensated heart failure(ADHF),and whether its predictive ability can be improved when combined with the Acute Decompensated Heart Failure National Registry Study(ADHERE)model.Methods A total of 821 consecutive patients with ADHF admitted to the Department of Cardiology of Nanjing Drum Tower Hospital from January 2018 to March 2021 were enrolled.The patients were divided into tertiles according to their ALBI score at admission:the low ALBI group(＜-2.41,n=273),the medium ALBI group(-2.41 to-2.10,n=274)and the high ALBI group(≥-2.10,n=274).The baseline clinical characteristics and laboratory tests were compared between groups,and the primary endpoint was short-term(in-hospital or within 30 days after discharge)all-cause death.Logistics regression was used to analyze the independent risk factors of short-term all-cause death.The receiver operating characteristic(ROC)curve was plotted.The area under the ROC curve(AUC)was calculated for each model,and the optimal threshold value was determined based on the Jorden index.The net reclassification index(NRI)was also calculated among different models.The Z test was used to compare the differences in AUC and NRI between the models.Results There were 45(5.48％)patients died in the hospital and within 30 days after discharge.The patients with ALBI score≥-2.10 had significantly higher short-term all-cause mortality than those in the other two groups(P＜0.001).Multivariate logistics regression analysis showed that ALBI score(OR=4.012,95％CI 1.598-10.073,P=0.003),ADHERE model(OR=2.471,95％CI 1.317-4.434,P=0.004)and B-type natriuretic peptide level(OR=1.000,95％CI 1.000-1.001,P=0.002)were the independent risk factors for short-term all-cause death in ADHF patients.The optimal cutoff value of ALBI score for predicting short-term death was-2.024.In addition,ALBI score combined with ADHERE model was better than the single score in predicting short-term all-cause mortality in patients with ADHF(ALBI+ADHERE vs.ADHERE:AUC P=0.008;NRI=0.37,95％CI 0.14-0.56,P＜0.001;ALBI+ADHERE vs.ALBI:NRI=0.37,95％CI 0.14-0.56,P＜0.001).Conclusion ALBI score is independently associated with short-term all-cause mortality risk in ADHF patients,and ALBI score combined with ADHERE model has higher predictive value.
维普
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