Albumin–Bilirubin and Platelet–Albumin–Bilirubin Grades Do Not Predict Survival After Transjugular Intrahepatic Portosystemic Shunt Creation

To evaluate the capability of albumin–bilirubin (ALBI) and platelet–albumin–bilirubin (PALBI) grades in predicting transplant-free survival (TFS) in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation. This single-center retrospective study included 342 ALBI and 337 PALBI patients (62% men; age 53–54 years) with cirrhosis (median MELD 15) and portal hypertension complications (variceal bleeding, 55%; ascites, 35%; other, 10%) who underwent TIPS between 1998 and 2017. Serum albumin, bilirubin, and platelet levels within 24 h prior to TIPS were used to calculate ALBI and PALBI grades. The influence of ALBI and PALBI grade on 30-day, 90-day, and overall post-TIPS TFS was assessed using C-indices, binary logistic regression, and the Cox proportional model, adjusting for Child–Pugh (CP) and MELD scores. The cohort spanned 110 (32%) and 232 (68%) ALBI grades 2 and 3 patients, and 40 (12%) and 297 (88%) PALBI grades 2 and 3 patients. While there were no differences in 30-day survival between ALBI and PALBI grades 2/3 (P > 0.05), 90-day and overall TFS showed statistically significant differences in survival between ALBI and PALBI grades 2/3 (P