Predictive power of ALBI score-based nomogram for 30-day mortality following transcatheter aortic valve implantation
Biomarkers in Medicine, cilt.19, sa.9, ss.305-316, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 19 Sayı: 9
- Basım Tarihi: 2025
- Doi Numarası: 10.1080/17520363.2025.2483157
- Dergi Adı: Biomarkers in Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, MEDLINE
- Sayfa Sayıları: ss.305-316
- Anahtar Kelimeler: ALBI, ALBI-based nomogram, 30-day mortality, severe aortic stenosis, TAVI, STS PROM, albumin-Bilirubin Score
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.