Albumin Is Predictive of 1-Year Mortality After Transcatheter Aortic Valve Replacement

Hebeler, Katherine R.; Baumgarten, Heike; Squiers, John J.; Wooley, Jordan; Pollock, Benjamin D.; Mahoney, Cecile; Filardo, Giovanni; Lima, Brian; DiMaio, J. Michael

doi:10.1016/j.athoracsur.2018.06.024

Cited by 43 publications

(26 citation statements)

References 24 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hebeler, et al reported that the STS score alone was poorly predictive of IMPACT OF SERUM ALBUMIN ON TAVR one-year mortality after TAVR, and albumin was the only frailty marker associated with higher mortality. 44) Hypoalbuminemia's likely relation to mortality in the TAVR population may be explained by various reasons. Albumin is commonly correlated with more severe comorbidities, such as malignancy (sometimes occult), acute or chronic infective diseases, nutritional status, diabetes mellitus, and renal failure.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Impact of Pre-Procedural Serum Albumin on Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement

Liu

Long

et al. 2020

Int. Heart J.

View full text Add to dashboard Cite

Pre-procedural serum albumin's impact on prognosis after transcatheter aortic valve replacement (TAVR) has been studied. Literature on the prognostic role of serum albumin in the survival of patients undergoing TAVR shows conflicting results. This meta-analysis was conducted to evaluate the impact of pre-procedural serum albumin on outcomes after TAVR. A comprehensive literature search of EMBASE, MEDLINE, and the Cochrane Library was undertaken through July 2019. The primary end points were 30-day and one-year all-cause mortality after TAVR. Risk ratios (HRs) and 95% confidence intervals (CIs) were calculated using the randomeffect model. Ten eligible studies with 8,236 patients were analyzed. Of the 8,236 patients undergoing TAVR, with a mean age of 83 years, 48.8% were men and were categorized into two groups according to low and normal serum albumin (cut-off value: 3.5 or 4 g/dL). Overall, low albumin was significantly associated with an approximately twofold increase in 30-day all-cause mortality (HR, 2.09; 95% CI, 1.53-2.86) and a 61% increase risk for one-year mortality (HR, 1.61; 95% CI, 1.31-1.98) in patients after TAVR. Sensitivity analyses showed the results to be robust. The association of low albumin level with an increase in one-year mortality risk was not modified by study design, albumin cutoff value, Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), and study quality. In conclusion, low albumin levels were associated with poor prognosis in patients after TAVR. Pre-procedural albumin can be used as a simple tool related to prognosis after TAVR.

show abstract

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Impact of Pre-Procedural Serum Albumin on Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement

Liu

Long

et al. 2020

Int. Heart J.

View full text Add to dashboard Cite

show abstract

“…Frailty, as defined in previous works, refers to patients with inpatient hypoalbuminemia and muscle weakness/fatigue. 18 Patients with diagnosis of infection, inflammatory spondyloarthropathies, neoplasm, pathologic or traumatic fractures, history of trauma or pregnancy were excluded from the study.…”

Section: Definition Of Casesmentioning

confidence: 99%

Effects of Body Mass Index on Perioperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion Surgery

et al. 2021

View full text Add to dashboard Cite

Objective Obesity has become a public health crisis and continues to be on the rise. An elevated body mass index has been linked to higher rates of spinal degenerative disease requiring surgical intervention. Limited studies exist that evaluate the effects of obesity on perioperative complications in patients undergoing anterior cervical discectomy and fusion (ACDF). Our study aims to determine the incidence of obesity in the ACDF population and the effects it may have on postoperative inpatient complications. Methods The National Inpatient Sample was evaluated from 2004 to 2014 and discharges with International Classification of Diseases procedure codes indicating ACDF were identified. This cohort was stratified into patients with diagnosis codes indicating obesity. Separate univariable followed by multivariable logistic regression analysis were performed for the likelihood of perioperative inpatient outcomes among the patients with obesity. Results From 2004 to 2014, estimated 1,212,475 ACDFs were identified in which 9.2% of the patients were obese. The incidence of obesity amongst ACDF patients has risen dramatically during those years from 5.8% to 13.4%. Obese ACDF patients had higher inpatient likelihood of dysphagia, neurological, respiratory, and hematologic complications as well as pulmonary emboli, and intraoperative durotomy. Conclusion Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF. Our data suggest that the number of obese patients undergoing ACDF is steadily increasing and had a higher inpatient likelihood of developing perioperative complications.

show abstract

“…Since the last century, physicians have linked hypoalbuminemia to the increase of mortality and morbidities [22]. New evidence has continuously emerged to indicate the important role that hypoalbuminemia can play in making accurate diagnosis and implementing effective treatment for critically ill patients [23,24,25,26]. Today, it seems to have reached a consensus among physicians that providing exogenous albumin to critically ill patients can lead to increased survival rate.…”

Section: Discussionmentioning

confidence: 99%

A Predicative Patient Specific Model for Human Albumin Based on Deep Neural Networks

Liu

Wang

Zhao

et al. 2020

Preprint

View full text Add to dashboard Cite

Background For a critically ill patient, an accurate predictive tool for biochemical markers based on the patient prior clinical data can aide physicians to design better patient-specific treatment plans. In this study, we develop a since dynamical system model based on neural networks capable of predicting concentrations of biochemical markers, including albumin, of a critically ill patient, in real-time. Methods The metabolic process of a patient follows a patient-specific dynamical system which can be uncovered with certain accuracy from sufficient prior data taken from the patient. For a given set of patient’s biochemical markers, the dynamical system represented by deep neural networks is discovered from the prior data via deep learning methods. Results One critically ill, poly-trauma patient (injury severity score = 34 points) was enrolled in the study. Six biochemical markers (albumin (ALB), creatinine (Cr), osmotic pressure (OSM), alanine aminotransferase (ALT), total bilirubin (TB), direct bilirubin (DB)) were collected and exogenous albumin injection was administered to the patient for the total of 27 consecutive days during the study. A sliding window of data in 10 consecutive days was used as the training set and the 11th day's data as the test set to train and test the parameters in the neural network. The obtained dynamical system model is then used to forecast the chemical markers in the next 24 hours. The results are compared with the true clinical data with a relative error consistently less than 2%. Conclusions This study demonstrates that a dynamic system model can be established to monitor and predict concentrations of biochemical markers, including albumin, via neural networks and deep learning methods. This data-driven patient-specific modeling approach is applicable to any patient. Trial registration Metabolomics Dynamics Study for Severe Patient, Registered:17June,2014, https://www.clinicaltrials.gov/ct2/show/NCT02164786?term=NCT02164786&draw=2&rank=1

show abstract

Albumin Is Predictive of 1-Year Mortality After Transcatheter Aortic Valve Replacement

Abstract: Most of the commonly used pre-TAVR risk assessments are poorly predictive of 1-year mortality. Albumin was the only frailty marker that was associated with higher mortality. Future studies should investigate whether optimization of nutritional status can improve outcomes after TAVR.

Cited by 43 publications

References 24 publications

Meta-Analysis of the Impact of Pre-Procedural Serum Albumin on Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement

Meta-Analysis of the Impact of Pre-Procedural Serum Albumin on Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement

Effects of Body Mass Index on Perioperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion Surgery

A Predicative Patient Specific Model for Human Albumin Based on Deep Neural Networks

Contact Info

Product

Resources

About