Albumin–Bilirubin (ALBI) Score Predicts Long-Term Survival in Elderly Patients with Decompensated Heart Failure

Background/Objective: Risk stratification in elderly patients with heart failure (HF) is very difficult. There is a lack of reliable tools for assessing the risk of death in this population of patients. The aim of this study was to determine the association between albumin–bilirubin (ALBI) score and long-term mortality in hospitalized elderly patients with decompensated HF. Methods: The study included 242 consecutive HF patients aged over 65 years hospitalized for worsening chronic HF at our institution between 2019 and 2023. The ALBI score was calculated according to the appropriate formula. Results: The median (IQR) age of the study population was 68.00 (range 66.0 to 74.6) years and 21.1% were female. The mean follow-up time was 352 ± 293 days. During the follow-up period, 47.1% patients died. The ALBI score generated good prognostic power (area under the curve = 0.822, p < 0.01) and specificity (86%) as well as acceptable sensitivity (68%) when predicting long-term mortality. Patients with higher ALBI scores (≥−2.191) had significantly worse long-term survival than patients with lower ALBI scores (<−2.191) [37 (25.2%) vs. 77 (81.1%); log rank p < 0.001]. Conclusions: This is the first study demonstrating that ALBI score has good prognostic power and allows for the successful prediction of mortality during long-term follow-up in the analyzed cohort.