Variceal bleeding is a poor prognostic factor for a patient with hepatocellular carcinoma. Chen et al reported a score that can help to identify a patient at low risk for variceal bleeding. The authors are from National Yang-Ming University and affiliated hospitals in Taiwan.
Patient selection: hepatocellular carcinoma
Parameters:
(1) serum albumin in g/L
(2) serum total bilirubin in µmol/L
(3) platelet count per microliter
ALBI score =
= (0.66 * LOG10(bilirubin)) - (0.085 * (albumin))
ALBI Score
Grade
<= -2.6
Grade 1
-1.39 to -2.59
Grade 2
> -1.39
Grade 3
Platelet Count
Points
> 150,000 per µL
1
<= 150,000 per µL
2
total score =
= (ALBI grade) + (points for platelet count)
Interpretation:
• minimum score: 2
• maximum score: 5
• A score of 2 has a 1.7% rate of variceal hemorrhage.
• A score of 3 to 5 had a 9.1% rate of variceal hemorrhage.
• Endoscopic screening for esophageal varices is not recommended if the score is 2.
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