Background and aims Accurate prognostication critical for managing liver cirrhosis. Existing tools Child-Pugh, model for end-stage liver disease (MELD), MELD-sodium (MELD-Na), Albumin-Bilirubin (ALBI), and platelet ALBI (PALBI) have limitations, including subjectivity, complexity, and reliance on logarithmic transformations. Simplified easy-ALBI (EZ-ALBI), a prognostic factor in hepatocellular carcinoma, is understudied in cirrhosis. The present study aimed to evaluate its prognostic value in cirrhosis, compare it with established scores, assess its consistent long-term performance, and define its clinical utility for risk stratification. Methods This retrospective study enrolled 501 cirrhotic patients (June 2018–June 2020), with a median follow-up of 42.3 months (interquartile range: 28.6–56.8 months); follow-up was terminated on 30 June 2025. EZ-ALBI was compared with Child-Pugh, MELD-Na, ALBI, and PALBI using correlation, survival (Kaplan–Meier), Cox regression, and receiver operating characteristic analyses. Results EZ-ALBI strongly correlated with ALBI ( r = 0.9460, P < 0.001). EZ-ALBI grade 3 was associated with shorter survival (29.9 vs. 65.5 months, P < 0.001) and served as an independent prognostic factor (hazard ratio = 3.944, 95% confidence interval: 1.772–8.777, P < 0.05). Its prognostic accuracy was consistent across 6–60 months (areas under the curves: 0.738–0.832), long-term performance (36–60 months) was comparable to MELD, MELD-Na, and ALBI, and outperformed Child-Pugh and PALBI in specific periods. Conclusion The EZ-ALBI score is a simple, objective, and reliable prognostic tool for patients with liver cirrhosis, with consistent predictive value across follow-up periods, supporting its clinical utility for risk stratification. Notably, EZ-ALBI’s simplicity (no logarithmic transformations) significantly enhances its practicality for bedside risk stratification, a key advantage in clinical practice.
Liu et al. (Tue,) studied this question.
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