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Pulimood, Thomas; Park, Gilbert R.

doi:10.1186/cc688

Cited by 72 publications

(31 citation statements)

References 45 publications

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“…Serum albumin is involved in a number of physiologic functions: regulation of plasma oncotic pressure (providing up to 65%–75% of normal colloid oncotic pressure) and capillary permeability, compound transport, and free radical scavenging [12, 13]. In critical illness, hypoalbuminemia is a function of loss due to vascular permeability, dilution with fluid resuscitation, and decreased albumin synthesis.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Acute Liver Failure in Patients With Acute Hepatitis A: An Analysis of the 2016–2018 San Diego County Hepatitis A Outbreak

Jiang

Greenwald

Sheikh

et al. 2019

Open Forum Infectious Diseases

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Background Between 2016 and 2018, San Diego County experienced a hepatitis A outbreak with a historically high mortality rate (3.4%) that highlighted the need for early recognition of those at risk of developing acute liver failure (ALF). Methods A retrospective case series of adult hospitalized patients with acute hepatitis A. Results One hundred six patients with hepatitis A were studied, of whom 11 (10.4%) developed ALF, of whom 7 (6.6%) died. A history of alcohol abuse, hyperbilirubinemia, hypoalbuminemia, hyponatremia, and anemia were associated with increased odds of developing ALF. Initial Maddrey’s and Model of End-Stage Liver Disease Sodium (MELD-Na) scores were also associated with the development of ALF. Multivariable analysis showed that a higher initial MELD-Na score (odds ratio [OR], 1.205; 95% confidence interval [CI], 1.018–1.427) and a lower initial serum albumin concentration (OR, 9.35; 95% CI, 1.15–76.9) were associated with increased odds of developing ALF. Combining serum albumin and MELD-Na (SAM; C-statistic, 0.8878; 95% CI, 0.756–0.988) yielded a model that was not better than either serum albumin (C-statistic, 0.852; 95% CI, 0.675–0.976) or MELD-Na (C-statistic, 0.891; 95% CI, 0.784–0.968; P = .841). Finally, positive blood cultures were more common among patients with ALF compared with those without ALF (63.6% vs 4.3%; P < .00001). Conclusions Hypoalbuminemia was associated with an increased risk of ALF in patients with acute hepatitis A. Positive blood cultures and septic shock as a cause of death were common among patients with ALF. Providers caring for patients with acute hepatitis A should monitor for early signs of sepsis and consider empiric antibiotics, especially in patients presenting with hypoalbuminemia.

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Section: Discussionmentioning

confidence: 99%

Predictors of Acute Liver Failure in Patients With Acute Hepatitis A: An Analysis of the 2016–2018 San Diego County Hepatitis A Outbreak

Jiang

Greenwald

Sheikh

et al. 2019

Open Forum Infectious Diseases

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“…Several studies have shown that albumin replacement therapy did not decrease the rates of death or major complications [20,21]. However, others found that treatment of hypoalbuminemic patients with exogenous human albumin solution resulted in a greater than twofold decrease in major complications [22,23].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for complications after bowel surgery in Korean patients with Crohn's disease

Song

Yoon

et al. 2012

J Korean Surg Soc

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PurposeTo assess the incidence and factors predictive of early postoperative complications in Korean patients who undergo surgery for Crohn's disease (CD).MethodsWe retrospectively assessed 350 patients (246 males, 104 females; mean age, 30 ± 9 years) who underwent surgery for primary or recurrent CD at Asan Medical Center between January 1991 and May 2010. The incidence and predictive factors of early postoperative complications were analyzed by both univariate and multivariate analyses.ResultsOf the 350 patients, 81 patients (23.1%) developed postoperative complications, the most common being septic complications (54 patients), including 19 cases of wound infection. Thirty patients (8.6%) required re-operations, and only one patient died. Multivariate analysis showed that four factors were independently associated with a high risk of early postoperative complications; preoperative moderate to severe anemia (hematocrit concentration <30%; odds ratio [OR], 3.1; 95% confidence interval [CI], 1.6 to 5.9), hypoalbuminemia (serum albumin level <3.0 g/dL; OR, 2.6; 95% CI, 1.4 to 4.7), emergency surgery (OR, 4.0; 95% CI, 1.5 to 10.6), and covering stoma (OR, 2.6; 95% CI, 1.3 to 5.4). Correction of preoperative moderate to severe anemia and hypoalbuminemia decreased the incidence of postoperative complications. Mean hospital stay was significantly longer in patients with than without postoperative complications (31.3 ± 27.2 days vs. 10.3 ± 3.8 days, P < 0.001).ConclusionPreoperative anemia, low albumin level, emergency surgery, and covering stoma significantly increased the risk of early postoperative complications in patients with CD. Correcting preoperatively deficient nutritional factors may reduce postoperative morbidities.

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“…All of these results indicate the importance of nutrition management in reducing the incidence of postoperative complications. However, simply albumin replacement therapy with exogenous human albumin solution did not decrease the rates of death or major complications, probably as the underlying etiology of hypoalbuminemia is not solved and exogenous albumin is rapidly degraded [ 20 , 42 ], so an integrated management of nutritional support to improve the serum albumin level and nutritional and physiological stabilization of patients is necessary.…”

Section: Discussionmentioning

confidence: 99%

Preoperative hypoalbuminemia is associated with an increased risk for intra-abdominal septic complications after primary anastomosis for Crohn’s disease

Liu

Zhou

et al. 2017

Gastroenterology Report

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ObjectiveThe aim of this study was to evaluate the impact of preoperative hypoalbuminemia on the development of intra-abdominal septic complications (IASCs) after primary anastomosis for patients with Crohn’s disease (CD).MethodsAll CD patients undergoing bowel resection with a primary anastomosis during the study period from 2007 to 2015 were enrolled. The association of preoperative hypoalbuminemia (<30 g/L) with the risk for IASCs were assessed using both univariate and multivariate analyses.ResultsA total of 124 eligible patients were included, 117 (94.4%) of whom had available preoperative albumin level. Preoperative hypoalbuminemia occurred in 13 (11.7%) patients. The duration from diagnosis to surgery was longer for patients with preoperative hypoalbuminemia than those without (p = 0.012). Patients with preoperative hypoalbuminemia were more likely to have a history of preoperative use of 5-aminosalicylic acid (p = 0.013) and have an intraoperative finding of small bowel obstruction (p = 0.015). Of all patients, 24 (19.4%) developed postoperative IASCs. Univariate analysis showed that patients with preoperative hypoalbuminemia had an increased risk for IASCs (p = 0.012). Multivariate analysis confirmed the association between preoperative hypoalbuminemia and IASCs (odds ratio 4.67, 95% confidence interval: 1.28–17.04, p = 0.02). Similar findings were also obtained when preoperative albumin level was analysed as a continuous variable (p = 0.019).ConclusionsPreoperative hypoalbuminemia is a significant predictor for the development of postoperative IASCs in CD patients after bowel resection with a primary anastomosis. Favorable preoperative nutrition status might lessen the risk for IASCs.

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Cited by 72 publications

References 45 publications

Predictors of Acute Liver Failure in Patients With Acute Hepatitis A: An Analysis of the 2016–2018 San Diego County Hepatitis A Outbreak

Predictors of Acute Liver Failure in Patients With Acute Hepatitis A: An Analysis of the 2016–2018 San Diego County Hepatitis A Outbreak

Risk factors for complications after bowel surgery in Korean patients with Crohn's disease

Preoperative hypoalbuminemia is associated with an increased risk for intra-abdominal septic complications after primary anastomosis for Crohn’s disease

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