Albumin–Bilirubin (ALBI) Score: Clinical Guide

Overview

Calculates the ALBI score from serum albumin and bilirubin.

Clinical Significance

Lower values indicate better liver function. Grade boundaries commonly used are ≤−2.60, >−2.60 to ≤−1.39, and >−1.39.

When to Use

• Use when the calculation is relevant to the clinical question.
• Confirm that the population and units match the validated method.
• Use current and reliable measurements.

How It Is Calculated

• ALBI = 0.66 × log10 bilirubin (µmol/L) − 0.085 × albumin (g/L).

Interpretation

• Lower values indicate better liver function. Grade boundaries commonly used are ≤−2.60, >−2.60 to ≤−1.39, and >−1.39.
• Interpret alongside the full clinical picture and current guidance.

Worked Example

Enter the required measurements in the stated units. MedicalC then applies: ALBI = 0.66 × log10 bilirubin (µmol/L) − 0.085 × albumin (g/L).

Patient Considerations

• Consider age, body size, pregnancy, organ function and treatment effects where relevant.
• Repeat the calculation when inputs or clinical status materially change.

Limitations

• Accuracy depends on the quality and units of the entered data.
• The equation may not be validated in every patient population.
• This tool does not replace clinical judgement or specialist advice.

Clinical Pearls

• Check units before calculating.
• Document the source and timing of each input.
• Use trends where clinically appropriate.

Common Mistakes

• Mixing SI and conventional units.
• Using non-contemporaneous measurements.
• Treating the output as a diagnosis or prescription.

Evidence Base

The implemented calculation follows the published or guideline-based relationship: ALBI = 0.66 × log10 bilirubin (µmol/L) − 0.085 × albumin (g/L).

References

1. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach. J Clin Oncol. 2015. — Primary publication, guideline or established source supporting the calculation.