Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock

Jäntti, Toni; Tarvasmäki, Tuukka; Harjola, Veli‐Pekka; Parissis, John; Pulkki, Kari; Javanainen, Tuija; Tolppanen, Heli; Jurkko, Raija; Hongisto, Mari; Kataja, Anu; Sionís, Alessandro; Silva-Cardoso, José; Banaszewski, Marek; Špinar, Jindřich; Mebazaa, Alexandre; Lassus, Johan

doi:10.1371/journal.pone.0217006

Cited by 32 publications

(24 citation statements)

References 36 publications

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“…Admission serum albumin level has been shown to be correlated with outcomes for general ward patients [ 35 , 36 ], and hospital mortality of critically ill patients [ 37 , 38 , 39 ]. Since we also observed that admission albumin level was associated with secondary clinical outcomes, admission albumin level was then adjusted to assess the association between energy intake and clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Full versus Trophic Feeds in Critically Ill Adults with High and Low Nutritional Risk Scores: A Randomized Controlled Trial

Wang

Chao

et al. 2020

Nutrients

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Although energy intake might be associated with clinical outcomes in critically ill patients, it remains unclear whether full or trophic feeding is suitable for critically ill patients with high or low nutrition risk. We conducted a prospective study to determine which feeding energy intakes were associated with clinical outcomes in critically ill patients with high or low nutrition risk. This was an investigator-initiated, single center, single blind, randomized controlled trial. Critically ill patients were allocated to either high or low nutrition risk based on their Nutrition Risk in the Critically Ill score, and then randomized to receive either the full or the trophic feeding. The feeding procedure was administered for six days. No significant differences were observed in hospital, 14-day and 28-day mortalities, the length of ventilator dependency, or ICU and hospital stay among the four groups. There were no associations between energy and protein intakes and hospital, 14-day and 28-day mortalities in any of the four groups. However, protein intake was positively associated with the length of hospital stay and ventilator dependency in patients with low nutrition risk receiving trophic feeding. Full or trophic feeding in critically ill patients showed no associations with clinical outcomes, regardless of nutrition risk.

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Section: Discussionmentioning

confidence: 99%

Full versus Trophic Feeds in Critically Ill Adults with High and Low Nutritional Risk Scores: A Randomized Controlled Trial

Wang

Chao

et al. 2020

Nutrients

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“…It is known that low levels of serum albumin, which are common in patients with critical illness, are associated with poor outcomes [94][95][96] . Some evidence indicates that the transcapillary escape rate of albumin increases in tandem with disease severity 97 .…”

Section: Prognostic Value Of Hypoalbuminemiamentioning

confidence: 99%

Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients

Wiedermann¹

2020

Current Medical Research and Opinion

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Objective: Positive fluid balance is common among critically ill patients and leads to worse outcomes, particularly in sepsis, acute respiratory distress syndrome, and acute kidney injury. Restrictive fluid infusion and active removal of accumulated fluid are being studied as approaches to prevent and treat fluid overload. Use of human albumin solutions has been investigated in different phases of restrictive fluid resuscitation, and this narrative literature review was undertaken to evaluate hypoalbuminemia and the roles of human serum albumin with respect to hypovolemia and its management.

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“…It is established that albumin has several functions including osmotic pressure regulation and antioxidant and anti-inflammatory effects [ 13 , 14 ]. One recent study showed that hypoalbuminemia was a frequent finding early in CS and was associated with mortality independent of other risk factors [ 15 ]. Recently, several studies have combined these two markers and found that the neutrophil percentage-to-albumin ratio (NPAR) could serve as an inflammation-based prognostic predictor in patients with STEMI [ 16 ], acute kidney injury [ 17 ], septic shock [ 18 ], rectal cancer [ 19 ], or palliative pancreatic cancer [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Neutrophil Percentage-to-Albumin Ratio as a New Predictor of All-Cause Mortality in Patients with Cardiogenic Shock

Liu

Ling

et al. 2020

BioMed Research International

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Background. Although the neutrophil percentage-to-albumin ratio (NPAR) has proven to be a robust systemic inflammation-based predictor of mortality in a wide range of diseases, the prognostic value of the NPAR in critically ill patients with cardiogenic shock (CS) remains unknown. This study aimed at investigating the association between the admission NPAR and clinical outcomes in CS patients using real-world data. Methods. Critically ill patients diagnosed with CS in the Medical Information Mart for Intensive Care-III (MIMIC-III) database were included in our study. The study endpoints included all-cause in-hospital, 30-day, and 365-day mortality in CS patients. First, the NPAR was analyzed as a continuous variable using restricted cubic spline Cox regression models. Second, X-tile analysis was used to calculate the optimal cut-off values for the NPAR and divide the cohort into three NPAR groups. Moreover, multivariable Cox regression analyses were used to assess the association of the NPAR groups with mortality. Results. A total of 891 patients hospitalized with CS were enrolled in this study. A nonlinear relationship between the NPAR and in-hospital and 30-day mortality was observed (all P values for nonlinear trend<0.001). According to the optimal cut-off values by X-tile, NPARs were divided into three groups: group I ( NPAR < 25.3 ), group II ( 25.3 ≤ NPAR < 34.8 ), and group III ( 34.8 ≤ NPAR ). Multivariable Cox analysis showed that higher NPAR was independently associated with increased risk of in-hospital mortality (group III vs. group I: hazard ratio [HR] 2.60, 95% confidence interval [CI] 1.72-3.92, P < 0.001 ), 30-day mortality (group III vs. group I: HR 2.42, 95% CI 1.65-3.54, P < 0.001 ), and 365-day mortality (group III vs. group I: HR 6.80, 95% CI 4.10-11.26, P < 0.001 ) in patients with CS. Conclusions. Admission NPAR was independently associated with in-hospital, 30-day, and 365-day mortality in critically ill patients with CS.

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Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock

Cited by 32 publications

References 36 publications

Full versus Trophic Feeds in Critically Ill Adults with High and Low Nutritional Risk Scores: A Randomized Controlled Trial

Full versus Trophic Feeds in Critically Ill Adults with High and Low Nutritional Risk Scores: A Randomized Controlled Trial

Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients

The Neutrophil Percentage-to-Albumin Ratio as a New Predictor of All-Cause Mortality in Patients with Cardiogenic Shock

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