THE IMPACT OF HYPOALBUMINEMIA ON OUTCOMES IN PATIENTS WITH SEPTIC SHOCK
Main Article Content
Abstract
Background: Hypoalbuminemia is commonly observed in critically ill patients due to various pathophysiological mechanisms and is associated with increased disease severity in sepsis. Objective: To evaluate the impact of hypoalbuminemia on treatment outcomes in patients with septic shock. Materials and methods: A cross-sectional study was conducted on 134 patients with septic shock, as defined by Sepsis-3, who were admitted to the Intensive Care Unit of Hoan My Cuu Long Hospital from January 2023 to October 2024. Results: The mean serum albumin level in the study was 2.69±0.50 g/dL. Hypoalbuminemia (<2.5 g/dL) was observed in 29.9% of patients. Multivariate logistic regression revealed that higher serum albumin levels (as a continuous variable) were associated with reduced odds of mortality (OR 0.21, 95% CI 0.08-0.56, p=0.002). The 30-day mortality rate was 70% in the hypoalbuminemia group (<2.5 g/dL) compared to 27.7% in the group with albumin levels ≥2.5 g/dL (HR 3.69, 95% CI 2.15-6.31, p <0.001). Furthermore, the hypoalbuminemia group had higher in-hospital mortality (52.5% vs. 24.5%, p=0.003), fewer ventilator-free days (8.35±13.1 vs. 20.6±13.4, p <0.001) and fewer hospital-free days (5.47±8.81 vs. 13.9±10.4, p <0.001) within 30 days compared to the group with albumin levels ≥2.5 g/dL. Conclusion: Serum albumin levels are inversely associated with mortality risk in patients with septic shock. Patients with hypoalbuminemia (<2.5 g/dL) had higher 30-day and in-hospital mortality rates, fewer ventilator-free days and fewer hospital-free days within 30 days compared to patients with albumin levels ≥2.5 g/dL.
Keywords
Hypoalbuminemia, mortality risk, septic shock
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Pompili M., Biolato M., Miele L., Grieco A. Tumor necrosis factor-α inhibitors and chronic hepatitis C: a comprehensive literature review. World J Gastroenterol. 2013. 19(44), 7867-73, DOI: 10.3748/wjg.v19.i44.7867.
3. Allison S.P., Lobo D.N. The clinical significance of hypoalbuminaemia. Clin Nutr. 2024. 43(4), 909-914, DOI: 10.1016/j.clnu.2024.02.018.
4. Yin M., Si L., Qin W., Li C., Zhang J., et al. Predictive Value of Serum Albumin Level for the Prognosis of Severe Sepsis Without Exogenous Human Albumin Administration: A Prospective Cohort Study. J Intensive Care Med. 2018. 33(12), 687-694, DOI: 10.1177/0885066616685300.
5. Kendall H., Abreu E., Cheng A. Serum Albumin Trend Is a Predictor of Mortality in ICU Patients with Sepsis. Biol Res Nurs. 2019. 21(3), 237-244, DOI: 10.1177/1099800419827600.
6. Singer M., Deutschman C.S., Seymour C.W., Hari M.S., Annane D., et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016. 315(8), 801-10, DOI: 10.1001/jama.2016.0287.
7. Bùi Thị Hương Giang, Đoàn Duy Thành, Nguyễn Tú Anh. Một số yếu tố tiên lượng tử vong tại ngày thứ 28 trên bệnh nhân sốc nhiễm khuẩn. Tạp chí Y học Việt Nam. 2024. 535(1), 99103, DOI: https://doi.org/10.51298/vmj.v535i1.8356.
8. Caironi P., Tognoni G., Masson S., Fumagalli R., Pesenti A., et al. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med. 2014. 370(15), 1412-21, DOI: 10.1056/NEJMoa1305727.
9. Frenkel A., Novack V., Bichovsky Y., Klein M., Dreiher J. Serum Albumin Levels as a Predictor of Mortality in Patients with Sepsis: A Multicenter Study. Isr Med Assoc J. 2022. 24(7), 454-459.
10. Cao Y., Su Y., Guo C., He L., Ding N. Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research. Clin Epidemiol. 2023. 15, 263-273, DOI: 10.2147/CLEP.S396247.