Journal of Clinical Hepatology
This article investigates the predictive value of the ratio of serum prealbumin to total bilirubin (PA/TBil) at admission for the 90-day mortality or liver transplantation prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF), and discusses its efficacy when combined with the Model for End-Stage Liver Disease (MELD) score. The study retrospectively analyzed the clinical data of 216 patients and found that PA/TBil is an independent prognostic factor (OR=0.16, P<0.001), and its predictive efficacy is significantly improved when combined with the MELD score (AUC reaches 0.811, better than a single indicator). The innovation lies in proposing PA/TBil as a simple, low-cost, and dynamically monitored composite indicator that can comprehensively reflect liver synthetic function and cholestasis status, which is more sensitive than a single indicator. Compared with traditional scoring systems, this ratio is more practical under conditions of limited resources, providing new ideas for clinical risk stratification and early intervention. The study also emphasizes the importance of multi-dimensional assessment of liver function, in line with the current trend of ACLF prognosis evaluation.
This study explores the predictive value of the prealbumin/bilirubin ratio (PA/TBil) and its combination with the MELD score for the short-term prognosis of patients with HBV-related acute-on-chronic liver failure (HBV-ACLF). The study found that both the PA/TBil ratio and the MELD score are independent prognostic factors for the 90-day prognosis of patients, and the combined prediction (AUC=0.811) is significantly better than a single indicator, indicating that the combined model has higher predictive efficacy. This ratio is easy to calculate, low-cost, and can be dynamically monitored, suitable for clinical environments with limited resources, which helps in early identification of high-risk patients and guiding timely intervention. In addition, PA/TBil comprehensively reflects liver synthetic function and the degree of cholestasis, which is more sensitive than a single indicator, in line with the current trend of multi-dimensional assessment of liver failure prognosis. Therefore, this study provides a practical and effective tool for clinical risk stratification management of HBV-ACLF patients, with significant application value.
Objective: To investigate the value of prealbumin-to-total bilirubin (PA/TBil) ratio on admission in predicting 90-day mortality or liv…
