Risk factors and prognosis of hypoalbuminemia in surgical septic patients

Abstract

The aim of this study was to investigate the risk factors of hypoalbuminemia and effects of different albumin levels on the prognosis of surgical septic patients. We preformed a retrospective clinical study including 135 adult patients from September 2011 to June 2014. The albumin levels and severity markers were recorded during the first 48 h after enrollment, and logistic regression analyses were used to determine the risk factors. The outcomes of patients with different albumin levels were also compared. The acute physiology and chronic health evaluation II (APACHE II) score (OR 1.786, 95% CI [1.379–2.314], P < 0.001), C-reactive protein (CRP) (OR 1.016, 95% CI [1.005–1.027], P = 0.005), and blood lactate (OR 1.764, 95% CI [1.141–2.726], P = 0.011) were established as the independent risk factors of hypoalbuminemia in patients with surgical sepsis. The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21–25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis. Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome. In conclusion, APACHE II score (≥14.5), CRP (≥34.25 mg/L), and blood lactate (≥.35 mmol/L) were established as the independent risk factors of hypoalbuminemia in the early stage of surgical sepsis. Patients with baseline albumin level ≤20 g/L had worse prognosis than that of albumin level ≥21 g/L. Albumin levels were negatively correlated the prognosis of surgical sepsis when below about 23 g/L.

Serum calcium as a biomarker of clinical severity and prognosis in patients with coronavirus disease 2019: a retrospective cross-sectional study

“…As of March 06, 94 patients were discharged from hospital, median hospital stay was 15 (IQR, [11][12][13][14][15][16][17][18] days. MODS developed in 17 (7.1%) patients, septic shock in 6 (2.5%) patients.…”

Людський Сироватковий Альбумін (Минуле Та Майбутнє)

“…Так, уровень ЧСА ниже 20 г/л при ожогах увеличивал риск летальности с 84% чувстви-тельностью и 83% специфичностью [10]. При хирур-гическом сепсисе каждое снижение концентрации альбумина на 1 г/л ниже уровня 23 г/л увеличивало внутрибольничную летальность на 19,4 %, степень полиорганной недостаточности -на 28,7 % [11]. Ме-таанализ [12] 90 когортных исследований доказал, что гипоальбуминемия выступает прогностическим биомаркером при острых заболеваниях.…”

Perbandingan Mortalitas antara Pemberian Albumin Intravena dan Tidak diberikan Albumin Intravena pada Pasien Sepsis dengan Kondisi Hipoalbuminemia dan Faktor yang Berpengaruh terhadap Mortalitas Pasien Sepsis

“…4 Hipoalbuminemia biasanya sering terjadi pada pasien lanjut usia, khususnya yang sedang menjalani perawatan di rumah sakit, atau pada pasien malnutrisi, dan pasien dengan penyakit kronis stadium lanjut. 5 Salah satu tata laksana hipoalbuminemia adalah dengan pemberian human serum albumin (HSA) eksogen. Bagaimanapun juga, meskipun beberapa indikasi klinis didukung oleh bukti ilmiah yang nyata, pemberian HSA eksogen pada beberapa situasi klinis masih diperdebatkan atau tidak disetujui berdasarkan evidence-based medicine.…”

“…Hal ini berbeda dengan penelitian yang dilakukan oleh Sun, dkk. 5 yang menyatakan bahwa kadar albumin <2 g/dL memiliki prognosis yang lebih buruk daripada pasien dengan kadar albumin >2 g/dL. Pada penelitian ini, ada beberapa subjek penelitian yang meskipun kadar albumin <2 mg/dl, masih bisa bertahan hidup dan kadar albumin pun menjadi meningkat sendiri tanpa pemberian suplementasi albumin intravena.…”