Yusra Yusra, Claudio Agustino
Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia — Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Introduction: Liver cirrhosis can be classified into three groups using the aspartate aminotransferase-to-platelet ratio index (APRI) score, which is a noninvasive technique. This study was designed to determine the differences between the albumin levels, prothrombin time (PT), and fibrinogen levels of the cirrhosis stages based on the APRI scores. Materials and Methods: This cross-sectional study included 60 patients who met the inclusion criteria based on their records from the Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia. The study analysis included the Kolmogorov–Smirnov test for the un—normalized data, including the albumin level (median = 2.91 g/dL) and PT (median = 1.8 s), and the normalized fibrinogen level (mean = 273.7117 mg/dL). Results: The analysis of variance (ANOVA) and Kruskal–Wallis test results showed significant differences between these three components based on the APRI score (all P < 0.05). The post hoc tests (Bonferroni for the ANOVA and Mann–Whitney U for the Kruskal–Wallis test) of the albumin levels showed a significant difference in the comparison between the APRI score of <0.5 group and >2 group. The post hoc tests of the PT showed significant differences in all the comparisons. The post hoc tests of the fibrinogen levels showed significant differences for the comparisons between the APRI score of <0.5 group and >2 group and between the APRI score = 0.5–2 group and >2 group. Conclusion: PT is the optimal biomarker to distinguish between each stage of liver cirrhosis compared to serum albumin or fibrinogen levels.
Keywords: Albumin, aspartate amino transferase-to-platelet ratio index score, fibrinogen, liver cirrhosis, prothrombin time.