The prognostic value of the direct bilirubin to albumin ratio in critically ill patients with cirrhosis: Insights from MIMIC-IV database

by XingYi Yang, GuangDong Wang, Zhang Min, LiHong Lv, Ji Yang

Background

Patients with severe cirrhosis are at a higher risk of mortality. This study aimed to investigate the association between the direct bilirubin-to-albumin ratio (DBAR) and 28-day mortality in critically ill cirrhotic patients using data from the publicly available MIMIC-IV database.

Methods

This study explores DBAR’s relationship with 28-day mortality in severe cirrhosis patients. We first conducted univariate and multivariate analyses to identify independent risk factors. Then, we used Kaplan-Meier (KM) survival analysis to assess DBAR’s link with survival time and created KM curves. DBAR’s predictive accuracy was evaluated using Receiver Operating Characteristic (ROC) analysis, and the relationship was examined using restricted cubic spline modeling and subgroup analyses.

Result

This study enrolled 509 cirrhotic patients with in-hospital and ICU mortality rates of 22.3% and 14.3%, respectively. Univariate and multivariate analyses revealed a significant association between DBAR and 28-day mortality risk, with a hazard ratio of 1.16 (95% CI: 1.10–1.24, p  Conclusion

The DBAR scoring system offers an efficient and user-friendly approach for assessing prognosis in critically ill cirrhotic patients.