Prognostic Value of Preoperative ALBI Score for Predicting Right Ventricular Dysfunction After Coronary Artery Bypass Surgery

INTRODUCTION: This study aimed to evaluate the prognostic utility of the albumin–bilirubin (ALBI) score in predicting right ventricular (RV) failure and postoperative outcomes in patients undergoing isolated coronary artery bypass grafting (CABG).
METHODS: A total of 265 patients who underwent elective isolated CABG between 2020 and 2024 at a single tertiary center were retrospectively analyzed. Patients were divided into two groups based on a preoperative ALBI cut-off value of -2.44. Preoperative, operative, and postoperative parameters were compared between groups. The primary outcome was postoperative RV failure. Secondary outcomes included in-hospital mortality, postoperative complications, and recovery metrics. Multivariate logistic regression was used to assess the independent association between ALBI and outcomes.
RESULTS: Patients with high ALBI scores (>-2.44) were significantly older and had worse preoperative profiles, including lower ejection fraction (p=0.003), higher CRP (p=0.017), bilirubin (p<0.001), and BUN (p=0.008). No statistically significant differences were observed in postoperative atrial fibrillation, ICU stay, mechanical ventilation time, reoperation, or mortality between groups. However, high ALBI scores were consistently associated with markers of frailty and systemic inflammation.
DISCUSSION AND CONCLUSION: While the ALBI score did not predict short-term postoperative complications or mortality in isolated CABG patients, it demonstrated strong correlations with known risk factors such as advanced age, hypoalbuminemia, and inflammation. ALBI may serve as a useful adjunct in preoperative risk assessment. Further prospective studies are needed to confirm its role in long-term outcome prediction.