Prognostic informativeness of functional activity and serum albumin concentration in patients in chronic critical illness with different disease outcomes

Abstract

The outcome in a chronic critical illness (CCI) after cerebral catastrophes occurs in 5-10% of patients in intensive care units and is accompanied by severe homeostasis disorders with a likely outcome in multiple organ failure. In this aspect there is a need for a deep study of the pathogenesis of a CCI with the identification of the most significant outcome criteria Purpose of the study: To reveal the prognostic in formativeness of functional activity and serum albumin concentration in patients in a CCI with different disease outcomes. Materials and methods: A comparative retrospective study was carried out of the concentration and functional activity (detoxifine efficiency - DTE) of serum albumin in 19 deceased (Group1) and 38 survived patients (Group 2) after cerebral catastrophic injury resulting in CCI. Samples for the study were obtained at the admission of patients, in the middle of the treatment and before discharge of patients. Results: It was established that in Group 1 the average value of albumin concentration and DTE decreased significantly, while in Group 2 values increased from the moment of admission to the discharge of patients. A ROC-analysis demonstrated a sufficiently high diagnostic informativeness of albumin DTE and concentration criteria, that differed in patients of Group 1 and 2 throughout all phases of the study. Conclusions: The outcome to a CCI after cerebral catastrophes is accompanied by changes in the concentration of serum albumin and violations of its functional activity – DTE. In patients with a fatal outcome, in contrast to patients with a positive effect of treatment, there is a progressive decrease in the concentration of serum albumin, which is combined with a pronounced decrease in its functional activity