The Association of Albumin-Bilirubin (ALBI) Grade with Mortality Risk in Trauma Patients with Liver Injuries

Sheng En Chou, Cheng Shyuan Rau, Wei Ti Su, Ching Hua Tsai, Shiun Yuan Hsu, Ching Hua Hsieh*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations


INTRODUCTION: The albumin-bilirubin (ALBI) grade objectively assesses liver function with better performance than the Child-Pugh and end-stage liver disease scores. However, the evidence is lacking on the ALBI grade in trauma cases. This study aimed to identify the association between the ALBI grade and mortality outcomes in trauma patients with liver injury.

METHODS: Data from 259 patients with traumatic liver injury at a level I trauma center between January 1, 2009, and December 31, 2021 were retrospectively analyzed. Independent risk factors for predicting mortality were identified using multiple logistic regression analysis. Participants were characterized by ALBI score into grade 1 (≤ -2.60, n = 50), grade 2 (-2.60 < and ≤ -1.39, n = 180), and grade 3 (> -1.39, n = 29).

RESULTS: Compared to survival (n = 239), death (n = 20) was associated with a significantly lower ALBI score (2.8±0.4 vs 3.4±0.7, p < 0.001). The ALBI score was a significant independent risk factor for mortality (OR, 2.79; 95% CI, 1.27-8.05; p = 0.038). Compared with grade 1 patients, grade 3 patients had a significantly higher mortality rate (24.1% vs 0.0%, p < 0.001) and a longer hospital stay (37.5 days vs 13.5 days, p < 0.001).

DISCUSSION: This study showed that ALBI grade is a significant independent risk factor and an useful clinical tool to discover liver injury patients who are more susceptible to death.

Original languageEnglish
Pages (from-to)279-286
Number of pages8
JournalRisk Management and Healthcare Policy
StatePublished - 2023

Bibliographical note

© 2023 Chou et al.


  • ALBI grade
  • albumin-bilirubin grade
  • liver function
  • liver injury
  • mortality
  • trauma


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