Hypoalbuminemia and Obesity in Orthopaedic Trauma Patients: Body Mass Index a Significant Predictor of Surgical Site Complications

Egbert, Ryan C.; Bouck, Trevor T.; Gupte, Nikhil; Pena, Miren M.; Dang, Khang H.; Ornell, Samuel S.; Zelle, Boris A.

doi:10.1038/s41598-020-58987-4

Cited by 14 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The normal range value of the serum albumin was 35‐55 g/L. Based on the previous research, we defined hypoalbuminemia as albumin less than 35 g/L 18 …”

Section: Methodsmentioning

confidence: 99%

Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity

Huang

Cheng

Kumar

et al. 2020

Journal of Medical Virology

287

256

View full text Add to dashboard Cite

The coronavirus disease 2019 has evolved into a pandemic rapidly. Most of the literature show that the elevated liver enzymes in COVID-19 are of little clinical significance. Lower albumin level is seen in severe COVID-19 and is not parallel to the changes in alanine aminotransferase and aspartate aminotransferase levels. We aimed to explore the impact of hypoalbuminemia in COVID-19. This retrospective cohort study included adult patients with confirmed COVID-19. The relationship between hypoalbuminemia and death was studied using binary logistic analysis. A total of 299 adult patients were included, 160 (53.5%) were males and the average age was 53.4 ± 16.7 years. The median time from the onset of illness to admission was 3 days (interquartile ranges, 2-5). Approximately one-third of the patients had comorbidities.Hypoalbuminemia (<35 g/L) was found in 106 (35.5%) patients. The difference in albumin was considerable between survivors and non-survivors (37.6 ± 6.2 vs 30.5 ± 4.0, P < .001). Serum albumin level was inversely correlated to white blood cell (r = -.149, P = .01) and neutrophil to lymphocyte ratio (r = −.298, P < .001). Multivariate analysis showed the presence of comorbidities (OR, 6.816; 95% CI, lymphopenia (OR, 13.130; 95% CI,) and hypoalbuminemia (OR, 6.394; 95% CI, 1.315-31.092) were independent predictive factors for mortality. In conclusion, hypoalbuminemia is associated with the outcome of COVID-19. The potential therapeutic value of albumin infusion in COVID-19 should be further explored at the earliest.

show abstract

“…The normal range value of the serum albumin was 35‐55 g/L. Based on the previous research, we defined hypoalbuminemia as albumin less than 35 g/L 18 …”

Section: Methodsmentioning

confidence: 99%

Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity

Huang

Cheng

Kumar

et al. 2020

Journal of Medical Virology

287

256

View full text Add to dashboard Cite

show abstract

“…Serum levels of albumin predict outcome in first-hit acute inflammatory conditions such as primary trauma [ 79 ], burns [ 80 ], or acute infections [ 81 ]. Acute inflammation elicits an acute phase reaction characterized by changes of albumin and other markers of inflammation [ 82 ] including CRP, which increases within hours after major surgery [ 83 ].…”

Section: Hypoalbuminemia and Disease Outcomesmentioning

confidence: 99%

“…An albumin level <3.5 g/dL was associated with ~2.5-fold increased risk of surgical site infections in orthopedics [ 155 ]. Hypoalbuminemia was independently associated with surgical site infections in several observational studies involving orthopedic surgery [ 79 , 155 , 156 ], but this has not yet been confirmed in prospective cohort studies.…”

Section: Hypoalbuminemia and Prognosis In Infectionsmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

142

View full text Add to dashboard Cite

Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.

show abstract

“…Decreased serum albumin is one of the most common laboratory alterations in COVID-19 patients that require hospitalization [ 16 , 17 ]. Hypoalbuminemia is also a central component of multiple conditions, such as cancer, cirrhosis, trauma, and sepsis [ 21 , 22 , 23 , 24 ]. As a matter of fact, low serum albumin is a mortality predictor in critically ill patients with sepsis and septic shock [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

The Combined Use of Cytokine Serum Values with Laboratory Parameters Improves Mortality Prediction of COVID-19 Patients: The Interleukin-15-to-Albumin Ratio

et al. 2021

View full text Add to dashboard Cite

Laboratory parameters display limited accuracy in predicting mortality in coronavirus disease 2019 (COVID-19) patients, as with serum albumin. Emerging evidence suggests that cytokine serum values may enhance the predictive capacity of albumin, especially interleukin (IL)-15. We thus investigated whether the use of the IL-15-to-albumin ratio enables improving mortality prediction at hospital admission in a large group of COVID-19 patients. In this prospective cross-sectional study, we enrolled and followed up three hundred and seventy-eight patients with a COVID-19 diagnosis until hospital discharge or death. Two hundred and fifty-five patients survived, whereas one hundred and twenty-three died. Student’s T-test revealed that non-survivors had a significant two-fold increase in the IL-15-to-albumin ratio compared to survivors (167.3 ± 63.8 versus 74.2 ± 28.5), a difference that was more evident than that found for IL-15 or albumin separately. Likewise, mortality prediction considerably improved when using the IL-15-to-albumin ratio with a cut-off point > 105.4, exhibiting an area under the receiver operating characteristic curve of 0.841 (95% Confidence Interval, 0.725–0.922, p < 0.001). As we outlined here, this is the first study showing that combining IL-15 serum values with albumin improves mortality prediction in COVID-19 patients.

show abstract

Hypoalbuminemia and Obesity in Orthopaedic Trauma Patients: Body Mass Index a Significant Predictor of Surgical Site Complications

Cited by 14 publications

References 22 publications

Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity

Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity

Hypoalbuminemia as Surrogate and Culprit of Infections

The Combined Use of Cytokine Serum Values with Laboratory Parameters Improves Mortality Prediction of COVID-19 Patients: The Interleukin-15-to-Albumin Ratio

Contact Info

Product

Resources

About