Prognostic Value of the Preoperative ALBI Score for Postoperative Bleeding After Isolated CABG

Background: The Albumin–Bilirubin (ALBI) score is an easy-to-use, objective marker of liver synthetic function that has demonstrated prognostic value in various cardiovascular conditions. However, its role in predicting postoperative bleeding after CABG has not been previously investigated. Methods: Patients were divided into two groups according to their median preoperative ALBI score (−2.97): Low ALBI (n = 78) and High ALBI (n = 79). The primary outcome was excessive postoperative bleeding, defined as cumulative drainage exceeding 1000 mL within the first 24 postoperative hours. Secondary outcomes included transfusion requirements, mechanical ventilation duration, and length of hospital stay. Correlation and regression analyses were performed to assess the relationship between the ALBI score and postoperative bleeding. Results: The High ALBI group demonstrated a significantly greater postoperative drainage volume (450 [350–700] mL vs. 350 [300–487.5] mL, p = 0.007), higher erythrocyte transfusion (p = 0.001) and fresh frozen plasma transfusion requirements (p = 0.034), and prolonged mechanical ventilation duration (p < 0.001) and hospital stay (p = 0.003) compared to the Low ALBI group. Spearman correlation analysis revealed a significant positive correlation between the ALBI score and drainage volume (rho = 0.272, p < 0.001), and thus the ALBI score was identified as a significant predictor of excessive postoperative bleeding exceeding 1000 mL (OR: 5.93, 95% CI: 1.63–21.60, p = 0.007). Conclusions: The preoperative ALBI score is an easy-to-use and readily available tool that may serve as an effective adjunct for identifying patients at an elevated risk of postoperative bleeding prior to isolated CABG.