As shown in Table 2, model I revealed that the non-SR group (hazard ratio HR: 6.649, 95% CI 3.581–12.344, p < 0.001), serum α-fetoprotein (AFP) ≥ 100 mg/mL (HR 2.979, 95% CI 1.587–5.595, p = 0.001), hepatitis B surface (HBsAg) positivity (HR 0.368, 95% CI 0.200–0.678, p = 0.001), and ALBI grade 2 or 3 (HR: 2.013, 95% CI 1.091–3.711, p = 0.025) were the independent factors for predicting the OS for patients with ruptured HCC. Here, AFP is linked to hepatocellular carcinoma.