Sepsis patients with complication of hypoglycemia and hypoalbuminemia are an early and easy identification of high mortality risk

Furukawa, Masashi; Kinoshita, Kosaku; Yamaguchi, Junko; Hori, Satoshi; Sakurai, Atsushi

doi:10.1007/s11739-019-02034-2

Cited by 37 publications

(35 citation statements)

References 42 publications

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“…The low albumin has been associated with adverse outcomes in various other disease conditions [18][19][20][21][22][23], as well as in COVID-19 patients who were hospitalized [9,10,24]. Kheir et al concluded in their study that higher albumin level on admission was associated with favorable outcomes in hospitalized COVID-19 patients [11].…”

Section: Plos Onementioning

confidence: 99%

Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

et al. 2021

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Background The data on the COVID-19 patients who were discharged to self-quarantine is lacking. Aim The aim of the study was to investigate the percentage of COVID-19 positive patients that were hospitalized within a three-week period after discharge from ED to self-quarantine. Methods The patients who had confirmed SARS-CoV-2 on RT-PCR of the nasopharyngeal swab and were discharged from ED of a tertiary care hospital in the USA to self-quarantine from March 01- July 31, 2020, were included. Patients were divided into two groups based on serum albumin levels and were followed up for three weeks to see if low level of albumin increased the risk of hospitalization. Univariate and multivariate logistic regression analyses were performed to study the effect of albumin level and outcomes. Results A total of 112 patients were included in the study out of which 65 had low serum albumin (<3.5 g/dL) and 47 had normal serum albumin (≥3.5 g/dL). More than 10% of patients discharged to self-quarantine needed hospitalization within three weeks. The Low albumin group had more co-morbidities at baseline. The low serum albumin group had 10 (15.38%) vs 2 (4.26%), p = 0.06 hospitalizations as compared to the normal serum albumin group. The multivariate logistic regression analysis did not reveal lower odds of hospitalization in the group with normal albumin, (OR 0.26, 95% CI 0.03–1.92, p = 0.19) after controlling for age, sex, and various co-morbidities. Conclusion The low serum albumin was not associated with the risk of hospitalization in COVID-19 patients who were initially discharged to self-quarantine.

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Section: Plos Onementioning

confidence: 99%

Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

et al. 2021

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“…Similarly, in hemodialysis, hypoalbuminemia affects the risk of sepsis in catheter-related bloodstream infection [ 130 ]. The mortality risk increases in septic patients if other conditions/markers that have predictive value are combined with serum albumin levels, as shown for ratios between serum albumin and blood glucose [ 131 ], serum albumin and lactate levels [ 132 , 133 ], or serum albumin and immature neutrophil counts [ 134 ].…”

Section: Hypoalbuminemia and Prognosis In Infectionsmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

142

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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.

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“…[ 22 ] Many studies have established that hypoalbuminemia is one of the strongest prognostic factors related to mortality, morbidity, and length of hospitalization, including mortality in elderly patients, people with chronic obstructive pulmonary disease, heart failure, malignancies, and sepsis. [ 23 – 25 ] Therefore, the association between hypoalbuminemia and 72-hours mortality in patients with extremely high RPG levels found in our study has a biological explanation.…”

Section: Discussionmentioning

confidence: 61%

Predicting 72-h mortality in patients with extremely high random plasma glucose levels

et al. 2021

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The risk factors associated with 72-hours mortality in patients with extremely high levels of random plasma glucose (RPG) remain unclear. To explore the risk factors predictive of 72-hours mortality in patients with extremely high RPG under heterogenos pathophysiological conditions. Retrospective, single-center, case-controlled cross-sectional study. University teaching hospital. Adults over age 18 were selected from the medical records of patients at the Saitama Medical Center, Japan, from 2004 to 2013. Extremely high RPG (≥500 mg/dl). Mortality at 72 hours following the RPG test, regardless of hospitalization or in an outpatient setting. Multivariate logistic regression analysis was performed with adjustment for age, sex, body mass index (BMI), and RPG level. The final prediction model was built using the logistic regression model with a higher C-statistic, specificity, and sensitivity. A total of 351 patients with RPG ≥500 mg/dl were identified within the 10-year period. The 72-hours mortality rate was 16/351 (4.6%). The C-statistics of the 72-hours mortality prediction model with serum albumin (ALB) and creatine kinase (CK) was 0.856. The probability of 72-hours mortality was calculated as follows: 1/[1 + exp (−5.142 + 0.901 log (CK) −1.087 ( ALB ) + 0.293 ( presence (1) or absence (0) of metastatic solid tumor )]. The sensitivity and specificity of this model was 75.5%. The independent risk factors associated with 72-hours mortality in patients with RPG ≥500 mg/dl are hypoalbuminemia, elevated CK, and presence of a metastatic solid tumour. Further research is needed to understand the mechanisms and possible interventions to prevent mortality associated with extremely high RPG.

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Sepsis patients with complication of hypoglycemia and hypoalbuminemia are an early and easy identification of high mortality risk

Cited by 37 publications

References 42 publications

Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

Hypoalbuminemia as Surrogate and Culprit of Infections

Predicting 72-h mortality in patients with extremely high random plasma glucose levels

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