Biomarkers in medicine · 2025
Predictive power of ALBI score-based nomogram for 30-day mortality following transcatheter aortic valve implantation.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Yildirim Abdullah, Genc Omer, Evlice Mert, Erdogan Aslan, Pacaci Emre, Ozderya Ahmet, Yerlikaya Murat Gokhan, Sezici Emre, Guler Yeliz, Sen Omer, Guler Ahmet, Akyuz Ali Riza, Korkmaz Levent, Kurt Ibrahim Halil
Аннотация
AIM: This retrospective, multi-center study evaluates the relationships between novel liver function scoring systems - Albumin-Bilirubin (ALBI) score, EZ-ALBI, PALBI, and MELD-XI - and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). Feature importance was assessed with SHAP-values via the XGBoost-algorithm.
RESULTS: The ALBI score exhibited the strongest association with 30-day mortality after TAVI (AUC = 0.723, p < 0.001), outperforming other scores in this regard and consistently demonstrating predictive power across various subgroup populations. Higher 30-day mortality rates were observed in the higher tertiles of the ALBI score compared to the lower tertiles (log-rank p-value = 0.004). The ALBI-based nomogram (C-index = 0.81, 95% CI:0.73-0.86, p = 0 < 001) demonstrated superior predictive power for 30-day mortality post-TAVI compared to the STS (C-index = 0.71, 95% CI :0.64-0.77, p = 0 < 001). In addition, the nomogram showed a significant improvement in reclassification (69.3%, p < 0.001) and a stronger discrimination 15.2%, p < 0.001) compared to the STS. It integrates nine variables, first ALBI score (SHAP:1.165), including NYHA class (0.594), body mass index (0.510), glomerular filtration rate, creatinine, hemoglobin, gender, predilatation requirement, presence of chronic kidney disease, and providing a comprehensive risk assessment tool.
CONCLUSION: This study exhibits the significance of liver dysfunction with AS patients and suggests incorporating liver function parameters in pre-operative risk assessments for better clinical outcomes in TAVI procedures.
RESULTS: The ALBI score exhibited the strongest association with 30-day mortality after TAVI (AUC = 0.723, p < 0.001), outperforming other scores in this regard and consistently demonstrating predictive power across various subgroup populations. Higher 30-day mortality rates were observed in the higher tertiles of the ALBI score compared to the lower tertiles (log-rank p-value = 0.004). The ALBI-based nomogram (C-index = 0.81, 95% CI:0.73-0.86, p = 0 < 001) demonstrated superior predictive power for 30-day mortality post-TAVI compared to the STS (C-index = 0.71, 95% CI :0.64-0.77, p = 0 < 001). In addition, the nomogram showed a significant improvement in reclassification (69.3%, p < 0.001) and a stronger discrimination 15.2%, p < 0.001) compared to the STS. It integrates nine variables, first ALBI score (SHAP:1.165), including NYHA class (0.594), body mass index (0.510), glomerular filtration rate, creatinine, hemoglobin, gender, predilatation requirement, presence of chronic kidney disease, and providing a comprehensive risk assessment tool.
CONCLUSION: This study exhibits the significance of liver dysfunction with AS patients and suggests incorporating liver function parameters in pre-operative risk assessments for better clinical outcomes in TAVI procedures.