Association between different concentrations of human serum albumin and 28-day mortality in intensive care patients with sepsis: A propensity score matching analysis

Abstract

Background: Human serum albumin (HSA) is a commonly used medication for the treatment of sepsis. However, there is no conclusive evidence as to whether different concentrations of HSA are associated with patient prognosis. This study aimed to evaluate the association between different concentrations of HSA and 28-day mortality in patients with sepsis.Methods: The data for this retrospective study were collected from the Medical Information Mart for Intensive Care IV database. Patients with sepsis were divided into two groups according to the concentration of HSA received: 25% and 5% HSA. The primary outcome of this study was the 28-day mortality in patients with sepsis. To ensure the robustness of our findings, we used multivariate Cox regression, propensity score matching, double-robust estimation, and inverse probability weighting models.Results: A total of 76,943 patients were screened, of whom 5,009 were enrolled. 1,258 and 3,751 patients received 25% and 5% HSA, respectively. The 28-day mortality rate was 38.2% (481/1,258) for patients in the 25% HSA group and 8.7% (325/3,751) for patients in the 5% HSA group. After propensity score matching, 1,648 patients were identified. The inverse probability weighting model suggested that 5% HSA received was associated with lower 28-day mortality (hazard ratio [HR]: 0.63, 95% confidence interval [CI]: 0.54–0.73, p < 0.001). Subgroup and sensitivity analysis confirmed the robustness of the results.Conclusion: In patients with sepsis, 5% HSA received may be associated with a lower risk of 28-day mortality than 25% HSA. Further randomized controlled trials are required to confirm this association.

The predictive values of admission characteristics for 28-day all-cause mortality in septic patients with diabetes mellitus: a study from the MIMIC database

“…Sepsis is still the leading cause of death in patients elected to the ICU (15,18). In the present study, the 28-day mortality rate of septic patients with DM was 23.9% (n=533), which was higher than in general septic patients (10%-15%) (34)(35)(36). Regarding the hospitalization characteristics of the study population, we observed that survivors showed longer hospital and ICU stays than non-survivors, which was consistent with previous studies (24, 37).…”

Research Progress of Macromolecules in the Prevention and Treatment of Sepsis

“…HSA regulates the blood osmotic pressure [ 87 ] and improves edema, hypoalbuminemia, glycocalyx degradation and hypovolemia caused by sepsis. A retrospective study involving 5009 patients with sepsis demonstrated that treatment with 5% HSA significantly reduced sepsis-related 28-day mortality (8.7%) [ 45 ]. In addition, albumin can also reduce heme-induced hepatic sinusoidal contraction and cytotoxicity, and improve liver microcirculation and organ function by binding heme.…”