ALBI Calculator
Use this premium Albumin-Bilirubin calculator to estimate ALBI score and ALBI grade from serum albumin and total bilirubin. The tool converts units automatically, shows the formula inputs in standard units, and visualizes where the result sits relative to key ALBI grade thresholds.
How to use this ALBI calculator
Enter the lab values exactly as reported by the laboratory. Choose the correct units for albumin and bilirubin, then click Calculate. The app converts values into standard ALBI units and returns both the score and grade.
- Albumin accepted as g/L or g/dL
- Bilirubin accepted as micromol/L or mg/dL
- Immediate chart visualization of grade position
- Reset option for quick recalculation
Interactive ALBI score calculator
This calculator is intended for educational and informational use. It does not replace diagnosis, staging, or treatment decisions by a qualified clinician.
What is an ALBI calculator?
An ALBI calculator is a clinical utility that estimates the Albumin-Bilirubin score, a liver function assessment model derived from only two objective laboratory values: serum albumin and total bilirubin. The name ALBI comes directly from those inputs. It was developed to provide a simple, reproducible way to describe hepatic reserve, especially in patients with hepatocellular carcinoma, but its usefulness has expanded into broader discussions of liver function, prognosis, and treatment planning. Because it relies on routine laboratory tests, the ALBI approach is attractive in clinical practice, research databases, and multidisciplinary tumor boards where consistency matters.
The key appeal of ALBI is that it strips away some of the subjectivity found in older bedside scoring systems. Instead of requiring clinician judgment about ascites or encephalopathy, it focuses on two quantifiable markers. Albumin reflects synthetic liver function and overall physiologic reserve, while bilirubin reflects hepatic excretory function. When those two markers are combined mathematically, the result is a continuous score that can then be grouped into standard ALBI grades.
This page calculates the score for you and displays the associated grade. It also converts common units automatically. That matters because many United States laboratories report bilirubin in mg/dL and albumin in g/dL, while the original ALBI formula uses bilirubin in micromol/L and albumin in g/L.
ALBI formula and grade cutoffs
The standard ALBI score is calculated with the following equation:
ALBI score = (log10 bilirubin in micromol/L × 0.66) + (albumin in g/L × -0.085)
After the score is computed, it is commonly interpreted using three grades:
- ALBI Grade 1: score less than or equal to -2.60
- ALBI Grade 2: score greater than -2.60 and less than or equal to -1.39
- ALBI Grade 3: score greater than -1.39
In general terms, a lower ALBI score suggests better liver function, while a higher score suggests worse liver functional reserve. However, interpretation always depends on the clinical setting, diagnosis, treatment goals, imaging findings, performance status, and additional laboratory markers.
Why the units matter
Correct unit conversion is essential. If bilirubin is entered in mg/dL but treated as micromol/L, the result will be substantially wrong. The same is true for albumin if g/dL is mistaken for g/L. That is why this calculator converts values before applying the formula. The standard conversions used here are:
- Bilirubin: 1 mg/dL = 17.1 micromol/L
- Albumin: 1 g/dL = 10 g/L
How clinicians use ALBI in practice
In hepatology and oncology, ALBI is most commonly discussed in the context of hepatocellular carcinoma. Patients with liver cancer often have two overlapping issues at the same time: tumor burden and underlying liver dysfunction. That creates a management challenge. A treatment that might be technically possible on imaging may not be physiologically safe if liver reserve is limited. ALBI helps frame that conversation by adding an objective liver function estimate to the overall clinical picture.
Clinicians may use ALBI when evaluating a patient for resection, ablation, transarterial therapy, radiation-based approaches, or systemic treatment. Researchers also use it for cohort stratification because the score is standardized and reproducible. Importantly, ALBI is not a replacement for comprehensive clinical assessment. It is one tool among many.
Typical scenarios where ALBI may be reviewed
- Baseline treatment planning: before deciding among local, regional, or systemic therapy.
- Follow-up trend analysis: repeated laboratory monitoring can show whether hepatic reserve appears stable, improving, or worsening.
- Research and risk stratification: ALBI can separate cohorts more objectively than systems with subjective bedside variables.
- Multidisciplinary discussions: surgeons, hepatologists, oncologists, and interventional radiologists often need a shared framework for liver function.
ALBI compared with other liver assessment models
ALBI is often discussed alongside Child-Pugh and MELD. These systems serve different purposes, so comparison should be thoughtful rather than competitive. Child-Pugh remains deeply embedded in liver disease care and incorporates albumin, bilirubin, INR, ascites, and encephalopathy. MELD, meanwhile, was developed for mortality risk estimation and transplant prioritization and uses bilirubin, creatinine, INR, and in newer versions sodium. ALBI is simpler and more objective than Child-Pugh, but it does not capture the full breadth of hepatic decompensation signs that clinicians observe at the bedside.
| Scoring model | Main inputs | Strengths | Limitations |
|---|---|---|---|
| ALBI | Albumin, bilirubin | Objective, simple, reproducible, useful in liver cancer discussions | Does not directly include INR, creatinine, ascites, or encephalopathy |
| Child-Pugh | Albumin, bilirubin, INR, ascites, encephalopathy | Widely known, clinically intuitive, long history of use | Includes subjective variables and broader category bins |
| MELD or MELD-Na | Bilirubin, creatinine, INR, with sodium in MELD-Na | Strong role in mortality prediction and transplant allocation | Designed for a different clinical purpose than ALBI |
Real-world liver cancer statistics that show why liver function assessment matters
When people search for an ALBI calculator, they are often dealing with liver cancer, cirrhosis, or a major hepatology evaluation. In that context, outcomes are influenced not only by cancer stage but also by liver reserve. One reason ALBI gained traction is that prognosis in hepatocellular carcinoma depends heavily on both tumor behavior and baseline hepatic function. The table below summarizes U.S. Surveillance, Epidemiology, and End Results program survival statistics for liver and intrahepatic bile duct cancer by stage at diagnosis.
| SEER summary stage | 5-year relative survival | Clinical meaning |
|---|---|---|
| Localized | 37% | Cancer appears confined to the liver area where it began |
| Regional | 13% | Spread to nearby structures or regional lymph nodes |
| Distant | 3% | Metastatic spread to distant organs or tissues |
| All SEER stages combined | 22% | Overall outcome across the full stage distribution |
Those statistics, published by the National Cancer Institute SEER program, show why treatment selection must be individualized. A patient with the same tumor stage may face a very different treatment path depending on the condition of the liver itself. That is exactly where ALBI can be useful: it adds an objective layer to clinical judgment when the care team is weighing safety, intensity, and expected tolerance of therapy.
How to calculate ALBI manually
If you ever want to verify the math by hand, the process is straightforward:
- Take the bilirubin value and convert it to micromol/L if necessary.
- Take the albumin value and convert it to g/L if necessary.
- Compute the base-10 logarithm of bilirubin in micromol/L.
- Multiply that logarithm by 0.66.
- Multiply albumin in g/L by -0.085.
- Add the two products together.
- Compare the final score with the ALBI grade cutoffs.
Example calculation
Suppose albumin is 3.8 g/dL and total bilirubin is 1.2 mg/dL. First convert the units:
- Albumin: 3.8 g/dL = 38 g/L
- Bilirubin: 1.2 mg/dL = 20.52 micromol/L
Then apply the formula:
log10(20.52) is approximately 1.312. Multiply 1.312 by 0.66 to get about 0.866. Multiply 38 by -0.085 to get -3.23. Add them together and the ALBI score is approximately -2.36. That falls into ALBI Grade 2.
Important interpretation points
An ALBI result should never be read in isolation. A good clinician asks several related questions: Is the bilirubin elevated because of intrinsic liver dysfunction, biliary obstruction, hemolysis, or another acute issue? Is albumin low because of chronic liver disease, inflammation, malnutrition, nephrotic loss, or volume status? Are the labs stable, or are they changing rapidly over time? Is the patient compensated or decompensated clinically? The calculator cannot answer those questions, but it can standardize the arithmetic.
It is also important to understand that ALBI was popularized largely in hepatocellular carcinoma literature, so its interpretation is strongest in contexts where it has been validated. That does not mean the score is meaningless elsewhere, but rather that the result should be used cautiously and in the right setting.
Common reasons for misleading results
- Entering direct bilirubin instead of total bilirubin
- Mixing up mg/dL and micromol/L
- Using albumin in g/dL without conversion
- Relying on very old lab values that no longer reflect the patient’s current condition
- Applying the score without considering infection, obstruction, acute injury, or nutritional factors
Authoritative resources for liver disease and liver cancer
If you want to go deeper than the calculator itself, the following resources are strong starting points:
- National Cancer Institute: Liver and bile duct cancer information
- National Institute of Diabetes and Digestive and Kidney Diseases: Liver disease overview
- MedlinePlus: Liver diseases
Who should use an ALBI calculator?
This tool is useful for clinicians, researchers, advanced practice providers, trainees, and well-informed patients who want a clearer understanding of how albumin and bilirubin combine within the ALBI framework. For physicians, it saves time and reduces arithmetic errors. For researchers, it supports consistent cohort categorization. For patients and families, it can make clinic discussions more understandable, especially when care teams mention ALBI grade while reviewing treatment options.
Best practices for using this page
- Use the most recent reliable lab values.
- Double-check that you selected the right units.
- Document the date and clinical context of the labs.
- Consider trend interpretation rather than relying on one isolated result.
- Review the score together with imaging, symptoms, physical findings, and other lab tests.
Final takeaway
The ALBI calculator is a streamlined way to estimate liver functional reserve using only albumin and bilirubin. Its simplicity is its strength. By reducing the process to objective laboratory values, ALBI can support clearer communication and more consistent interpretation in hepatology and liver oncology settings. At the same time, it should be treated as one component of a larger clinical picture rather than a stand-alone decision-maker. If you are using this score in a real medical setting, confirm the result against the original laboratory report and interpret it in consultation with a qualified healthcare professional.