Hipoalbuminemia como predictor de mortalidad en sepsis de origen abdominal

Abstract

Antecedentes: Un valor de albúmina < 35 g/l (hipoalbuminemia) ha demostrado ser un parámetro para predecir mortalidad y morbilidad. Método: Estudio observacional, prospectivo, en un periodo de 12 meses, en pacientes con diagnóstico de sepsis de origen abdominal a quienes se dividió en dos grupos según las cifras de albúmina (corte: 3.5 g/dl) para valorar la mortalidad en ambos grupos Resultados: Estudiamos 23 pacientes ingresados a la unidad de terapia intensiva. La media de albúmina fue de 2.77 g/dl (± 0.71). Al calcular la odds ratio (OR) identificamos un riesgo 23 veces mayor de fallecer al presentar hipoalbuminemia en comparación con el grupo con albúmina normal (OR = 23.3; intervalo de confianza del 95% [IC 95%]: 1.948 a 279.42). La media de los valores de albúmina para los pacientes que fallecieron fue de 2.04 g/dl (± 0.31) vs. a 3.03 g/dl (± 0.35) para el otro grupo (IC 95%: −1.551 a −0.416; p = 0.02)]. Aunque no valoramos la morbilidad, identificamos cierta tendencia a un mayor tiempo de estancia en la unidad de terapia intensiva, lo que se acompaña de mayor riesgo de complicaciones y de un mayor riesgo de muerte. Conclusión: La hipoalbuminemia representa un predictor de mortalidad en los pacientes con sepsis abdominal.

Hypoalbuminemia as Surrogate and Culprit of Infections

“…Sepsis is a common cause of mortality in ICUs, and low serum albumin levels in the acute phase are associated with increased risks of severity [ 116 ] and death in patients who develop severe sepsis and organ failure [ 81 , 117 , 118 , 119 ]. The predictive value of low serum albumin is independent of the site of infection [ 120 , 121 , 122 ] and independent of the patients’ age, even considering newborn and pediatric patients with sepsis [ 123 , 124 , 125 ]. Serum albumin of 2.45 g/dL was identified as the cut-off value to define hypoalbuminemia that was optimal for the prediction of short and long-term mortality in patients with septic shock [ 126 ].…”

Predictive value of combined diagnosis of albumin with alkaline phosphatase or monocyte percentage on the first day of admission to hospital for the risk of death from sepsis

“…21 In this study, 185 patients with sepsis were divided into two groups: death group and survivors.The results showed that the levels of MONO%, HGB, PLT, TP and ALB in the death group were signi cantly decreased compared with the survival group (P < 0.05), while the level of ALP in the death group was signi cantly increased compared with the survival group (P < 0.05).LYMPH (%) WBC (109/l), NEUT (%), EO (%), BASO (%), INR, FIB (g/l), G (g/l), TBIL (umol/l), ALT (u/l), AST (u/l), GGT (u/l), CRE (µmol/l), UA (µmo/l) and eGFR were not signi cantly different between the two groups (P > 0.05). Studies have shown that hypoalbuminemia is associated with poor prognosis in critically ill patients with sepsis, 22,23 the level of peripheral blood monocytes was negatively correlated with the severity of sepsis, 24,25 elevated alkaline phosphatase is associated with death from sepsis. 26 The results of this study are consistent with related studies.Whether ALB, MOMO%, or ALP alone was an independent indicator associated with an increased risk of sepsis death.This study evaluated whether the combination of these laboratory measures would increase the diagnostic value of the risk of death in patients with sepsis.…”

Prediction of Poor Outcome Using the Urea to Albumin Ratio in Thoracic Empyema

“…Hypoalbuminemia also significantly affects the pharmacokinetics and pharmacodynamics of anti-infective therapy, which further complicates the disease severity [8]. Various studies have reported an association between lower albumin levels and mortality in patients with thoracic empyema [5,10,11], pneumonia [12], lung cancer [13], and sepsis [14,15].…”