Predictive Value of Serum Albumin Level for the Prognosis of Severe Sepsis Without Exogenous Human Albumin Administration: A Prospective Cohort Study

Yin, Ming; Liu, Si; Qin, Weidong; Li, Chen; Zhang, Jianning; Yang, Hongna; Han, Hui; Zhang, Fan; Ding, Shifang; Zhou, Min; Wu, Dawei; Chen, Xiaomei; Wang, Hao

doi:10.1177/0885066616685300

Cited by 112 publications

(121 citation statements)

References 38 publications

(40 reference statements)

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“…Correspondingly, weaning from MV may cause respiratory muscle fatigue and, in turn, increase the risk of weaning failure [20]. In addition, the plasma albumin level is closely related to the prognosis of critical patients, especially elderly, hospitalized patients such that the lower the plasma albumin level is, the poorer are the nutritional status and the prognosis, and vice versa [21]. In other words, severe patients tend to be associated with an extraordinary weaning risk.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Analysis of Elderly Patients with Multiple Organ Dysfunction Syndrome Undergoing Invasive Mechanical Ventilation

Xiao

Liu

Guan

et al. 2020

Journal of Healthcare Engineering

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Objective. To prospectively investigate early prognostic assessments of patients with Multiple Organ Dysfunction Syndrome in the Elderly (MODSE) who were receiving invasive mechanical ventilation (IMV). Methods. e clinical data of 351 patients were enrolled prospectively between January 2013 and January 2018.e Acute Physiology and Chronic Health Evaluation II (APACHE II), APACHE III, Simplified Acute Physiology Score (SAPS II), and Multiple Organ Dysfunction Score (MODS) were calculated. According to the outcome of 28-day, the patients were divided into survivors and nonsurvivors. Additionally, based on whether weaning could be implemented, all patients were divided into a successful-weaning group and a failure-to-wean group. Results. According to the prognosis, the areas under the receiver operating characteristic curve of the APACHE II, APACHE III, SAPS II, and MODS scoring systems were 0.837, 0.833, 0.784, and 0.860, respectively. MODS exhibited the highest sensitivity, whereas APACHE II showed the highest specificity, and successful weaning was conducive to ameliorating patients' prognosis. Multivariate logistic regression analyses revealed that underlying lung disease, plasma albumin, serum creatinine level, number of failing organs, and IMV duration were related to prognosis of weaning, with odds ratios (ORs) of 1.447, 0.820, 1.603, 2.374, and 3.105, respectively. Conclusions. e APACHE II, APACHE III, SAPS II, and MODS systems could perform excellent prognostic assessment for patients with Multiple Organ Dysfunction Syndrome in the elderly. Underlying lung disease, plasma albumin, serum creatinine, number of failing organs, and IMV duration were independent prognostic factors of weaning in MODSE patients with invasive mechanical ventilation.

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Section: Discussionmentioning

confidence: 99%

Prognostic Analysis of Elderly Patients with Multiple Organ Dysfunction Syndrome Undergoing Invasive Mechanical Ventilation

Xiao

Liu

Guan

et al. 2020

Journal of Healthcare Engineering

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“…Independently of the immunological explanation, however, this study revealed that the serum albumin dosage can predict the outcome of acute‐subacute PCM cases. Several studies have demonstrated that serum albumin levels can be used as a prognostic factor for other infectious diseases, such as community‐acquired pneumonia, severe sepsis and bacteremia, although the physiopathology of such a predicting power has not been completely elucidated …”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated that serum albumin levels can be used as a prognostic factor for other infectious diseases, such as community-acquired pneumonia, severe sepsis and bacteremia, although the physiopathology of such a predicting power has not been completely elucidated. [40][41][42] The main antifungal agent employed for the treatment of acutesubacute PCM in this cohort was SMX-TMP. During the last decades, it has been the most recommended drug for that propose, since it is a low-cost efficient drug against Paracoccidioides spp, with well-known and easy-handled side effects.…”

Section: Discussionmentioning

confidence: 99%

Acute‐subacute paracoccidioidomycosis: A paediatric cohort of 141 patients, exploring clinical characteristics, laboratorial analysis and developing a non‐survival predictor

Romaneli

Tardelli

Tresoldi

et al. 2019

Mycoses

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Summary The acute‐subacute form of paracoccidioidomycosis (PCM) is a severe systemic mycosis that affects children and adolescents from endemic regions, leading to generalised lymphadenopathy, fever, weight loss, anaemia, eosinophilia, hypoalbuminemia and hypergammaglobulinemia. The objective of this study is to describe the clinical and laboratorial characteristics of acute‐subacute PCM, to determine a mortality risk factor and to propose a test for non‐survival hazard related to the disease. Children and adolescents diagnosed with PCM, under 15 years were included in the study. Their epidemiological, clinical and laboratorial data were obtained from the hospital records. Descriptive analysis, comparison of means, univariate logistic regression, multivariate logistic regression and a ROC curve were performed in order to identify significant information (P < .05). Through a period of 38 years, 141 children and adolescents were diagnosed with acute‐subacute PCM. The main antifungal agent used for the treatment was sulfamethoxazole‐trimethoprim (SMX‐TMP). The complication rate was 17%, the relapse rate was 7.8% and the mortality rate was 5.7%. A low albumin dosage was identified as a predictor factor for mortality. The cut‐off for serum albumin was 2.18 g/dL, above which, the survival rate is 99.1%. Thus, simple clinical and laboratorial examinations may lead to the diagnosis of acute‐subacute PCM, and the beginning of the treatment is encouraged even before the isolation of the fungus in biological samples, preventing unfavourable outcomes. Patients with an albumin dosage ≤ 2.18g/dL must receive special attention, preferably hospitalised, during the first four weeks of treatment for presenting an elevated mortality hazard.

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“…2 Konsentrasi serum albumin merupakan prediktor yang kuat terhadap prognosis dan mortalitas pada pasien non operatif maupun operatif. 3 Hipoalbuminemia didefinisikan sebagai keadaan serum albumin <3,5 g/dl, meskipun hipoalbuminemia yang bermakna klinis akan didapatkan dalam kadar albumin < 2,5 g/dl. 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.…”

Section: Pendahuluanunclassified

“…Rendahnya konsentrasi serum albumin merupakan prediktor yang kuat untuk prognosis yang buruk pada pasien non operatif. 3 Kadar albumin dari beberapa penelitian juga dianggap berpengaruh terhadap mortalitas pada pasien sepsis. 14 Meskipun didapatkan suatu hubungan antara kondisi klinis akhir dengan kadar serum albumin, hal ini jarang memberikan peranan penting pada pendekatan klinis pada pasien non operatif.…”

Section: Diskusiunclassified

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

Marzuki

Supriono

Pratomo

et al. 2020

JPDI

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Pendahuluan. Hipoalbuminemia merupakan prediktor kuat terhadap mortalitas pada pasien non operatif maupun operatif. Albumin berperan mempertahankan tekanan onkotik pada kondisi kritis seperti sepsis. Pemberian human serum albumin (HSA) eksogen pada sepsis dengan kondisi hipoalbuminemia masih kontroversial dengan hasil luaran yang bervariasi. Penelitian ini dilakukan untuk mengetahui perbandingan mortalitas antara pasien sepsis dengan kondisi hipoalbuminemia yang diberikan albumin intravena dan tanpa pemberian albumin intravena serta mengetahui faktor yang berpengaruh terhadap mortalitas pasien sepsis. Metode. Penelitian observasional dengan pendekatan prospektif melibatkan 75 subjek penelitian usia >18 tahun dengan sepsis disertai hipoalbuminemia (<2,5 g/dL) yang dirawat di ruangan high care unit RSUD dr. Saiful Anwar Malang selama periode 1 September 2018-31 Agustus 2019 yang terbagi menjadi dua kelompok, yaitu kelompok albumin dan nonalbumin. Kedua kelompok diikuti selama hospitalisasi sampai pulang atau meninggal dunia. Perbedaan mortalitas antara kedua kelompok dianalisis dengan uji bivariat chi square. Faktor yang paling berpengaruh terhadap mortalitas dianalisis dengan uji multivariat regresi logistik berganda. Hasil. Didapatkan 39 orang (52%) dari kelompok albumin dan 36 orang (48%) dari kelompok non albumin. Perbedaan jumlah mortalitas antara kelompok albumin dan nonalbumin {25 (64,1%) vs. 16 (44,4%) yang mana perbedaan tersebut tidak bermakna secara statistik dengan nilai OR 2 (p=0,138}. Faktor yang berpengaruh terhadap mortalitas antara lain: skor SOFA (OR 34,27, p<0,001), nilai MAP (OR 8, p<0,001), kondisi syok septik (OR 4,31, p=0,03), diabetes melitus (OR 0,28, p=0,009), kondisi gagal nafas (OR 8,02, p<0,001), penurunan kesadaran (OR 64,75, p<0,001), gagal kardiovaskular (OR 6, p<0,001), dan kondisi gagal hematologi (OR 3,05, p=0,027). Faktor yang paling dominan berpengaruh terhadap mortalitas pasien sepsis adalah penurunan kesadaran (OR 2,67, p=0,001). Simpulan. Pemberian transfusi albumin tidak memberikan perbedaan bermakna terhadap kejadian mortalitas pada pasien sepsis dengan kondisi hipoalbuminemia. Faktor yang paling berpengaruh terhadap mortalitas pasien sepsis adalah kondisi penurunan kesadaran.

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Predictive Value of Serum Albumin Level for the Prognosis of Severe Sepsis Without Exogenous Human Albumin Administration: A Prospective Cohort Study

Abstract: Having excluded potential confounding effect of exogenous albumin administration, low serum albumin levels are associated with an increased risk of death in patients with severe sepsis.

Cited by 112 publications

References 38 publications

Prognostic Analysis of Elderly Patients with Multiple Organ Dysfunction Syndrome Undergoing Invasive Mechanical Ventilation

Prognostic Analysis of Elderly Patients with Multiple Organ Dysfunction Syndrome Undergoing Invasive Mechanical Ventilation

Acute‐subacute paracoccidioidomycosis: A paediatric cohort of 141 patients, exploring clinical characteristics, laboratorial analysis and developing a non‐survival predictor

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

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