Fagenson AM, et al. - Researchers sought to validate and compare albumin-bilirubin score (ALBI) and MELD in predicting post hepatectomy outcomes. From the 2014-17 ACS-NSQIP Procedure Targeted Participant Use File, they identified 13,783 patients who were undergoing major hepatectomy (≥ 3 segments) or partial hepatectomy (≤ 2 segments). The median ALBI score of -2.6 and the median MELD score of 6.9 were observed. Severe post hepatectomy liver failure (Grades B-C) and mortality rates of 2.9% and 1.8%, respectively, were evident. The analysis revealed that for post hepatectomy liver failure and mortality, ALBI is a powerful predictor. Relative to MELD, ALBI exhibited higher predictive accuracy particularly in patients with hepatocellular carcinoma. ALBI grade 2/3 was identified to have stronger predictive value than MELD ≥ 10 for severe post hepatectomy liver failure and mortality.