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This retrospective cohort study, utilizing data from the MIMIC\u2010IV (v3.0) database, aimed to assess ALBI\u2019s predictive value for 28\u2010day all\u2010cause mortality in 338 adult ARDS patients admitted to the ICU. Patients were stratified into survivors (209 cases) and nonsurvivors (129 cases), with a 28\u2010day mortality rate of 38.2%. Multivariable Cox regression identified ALBI as an independent predictor of 28\u2010day mortality (HR\u2009=\u20091.46, 95% CI: 1.09\u20131.95,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.011). Receiver operating characteristic (ROC) analysis yielded an area under the curve (AUC) of 61.1% (95% CI: 54.7%\u201367.4%) with an optimal ALBI cutoff of \u22121.681; Kaplan\u2013Meier (KM) survival curves confirmed significantly higher mortality in patients with ALBI \u2265\u22121.681 versus ALBI &lt;\u22121.681 (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.0098). Subgroup analyses revealed no significant interactions between ALBI and clinical variables (interaction\n                    <jats:italic>p<\/jats:italic>\n                    : 0.672\u20130.85). These findings demonstrate ALBI\u2019s utility as a novel, independent prognostic marker for short\u2010term mortality risk in ARDS patients.\n                  <\/jats:p>","DOI":"10.1155\/mi\/9930648","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T15:18:58Z","timestamp":1752506338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Albumin\u2013Bilirubin (ALBI) Grade With 28\u2010Day All\u2010Cause Mortality in Patients With Acute Respiratory Distress Syndrome: A Retrospective Analysis of the MIMIC\u2010IV 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