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Risk factors and prognosis of hypoalbuminemia in surgical septic patients.

Sun JK, Sun F, Wang X, Yuan ST, Zheng SY, Mu XW - PeerJ (2015)

Bottom Line: The outcomes of patients with different albumin levels were also compared.The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21-25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis.Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.

ABSTRACT
The aim of this study was to investigate the risk factors of hypoalbuminemia and effects of different albumin levels on the prognosis of surgical septic patients. We preformed a retrospective clinical study including 135 adult patients from September 2011 to June 2014. The albumin levels and severity markers were recorded during the first 48 h after enrollment, and logistic regression analyses were used to determine the risk factors. The outcomes of patients with different albumin levels were also compared. The acute physiology and chronic health evaluation II (APACHE II) score (OR 1.786, 95% CI [1.379-2.314], P < 0.001), C-reactive protein (CRP) (OR 1.016, 95% CI [1.005-1.027], P = 0.005), and blood lactate (OR 1.764, 95% CI [1.141-2.726], P = 0.011) were established as the independent risk factors of hypoalbuminemia in patients with surgical sepsis. The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21-25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis. Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome. In conclusion, APACHE II score (≥14.5), CRP (≥34.25 mg/L), and blood lactate (≥.35 mmol/L) were established as the independent risk factors of hypoalbuminemia in the early stage of surgical sepsis. Patients with baseline albumin level ≤20 g/L had worse prognosis than that of albumin level ≥21 g/L. Albumin levels were negatively correlated the prognosis of surgical sepsis when below about 23 g/L.

No MeSH data available.


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The ROC curve analyses for APACHE II score (A), CRP (B), blood lactate (C) and the combination of three factors (D) on predicting hypoalbuminemia in surgical sepsis.
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fig-2: The ROC curve analyses for APACHE II score (A), CRP (B), blood lactate (C) and the combination of three factors (D) on predicting hypoalbuminemia in surgical sepsis.

Mentions: The ROC curves were performed to assess the value of APACHE II score, CRP, and blood lactate on predicting hypoalbuminemia in sepsis. As Fig. 2 presented, the area under curves (AUCs) of APACHE II score, CRP, and blood lactate were up to 0.933 (P < 0.001), 0.842 (P < 0.001), and 0.790 (P < 0.001), respectively. However, no difference (P > 0.05) was found in combination of the three factors though it had a higher AUC value (0.962). Optimal cut-off points for the three factors were also derived from ROC curves. Using cut-off points of 14.5 APACHE II score, 34.25 mg/L CRP, and 2.35 mmol/L blood lactate, the sensitivity of these factors in predicting hypoalbuminemia were respectively 90.5%, 86.3%, and 73.7%, and the corresponding specificity were 80.0%, 70.0%, and 75.0%, respectively.


Risk factors and prognosis of hypoalbuminemia in surgical septic patients.

Sun JK, Sun F, Wang X, Yuan ST, Zheng SY, Mu XW - PeerJ (2015)

The ROC curve analyses for APACHE II score (A), CRP (B), blood lactate (C) and the combination of three factors (D) on predicting hypoalbuminemia in surgical sepsis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4636415&req=5

fig-2: The ROC curve analyses for APACHE II score (A), CRP (B), blood lactate (C) and the combination of three factors (D) on predicting hypoalbuminemia in surgical sepsis.
Mentions: The ROC curves were performed to assess the value of APACHE II score, CRP, and blood lactate on predicting hypoalbuminemia in sepsis. As Fig. 2 presented, the area under curves (AUCs) of APACHE II score, CRP, and blood lactate were up to 0.933 (P < 0.001), 0.842 (P < 0.001), and 0.790 (P < 0.001), respectively. However, no difference (P > 0.05) was found in combination of the three factors though it had a higher AUC value (0.962). Optimal cut-off points for the three factors were also derived from ROC curves. Using cut-off points of 14.5 APACHE II score, 34.25 mg/L CRP, and 2.35 mmol/L blood lactate, the sensitivity of these factors in predicting hypoalbuminemia were respectively 90.5%, 86.3%, and 73.7%, and the corresponding specificity were 80.0%, 70.0%, and 75.0%, respectively.

Bottom Line: The outcomes of patients with different albumin levels were also compared.The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21-25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis.Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.

ABSTRACT
The aim of this study was to investigate the risk factors of hypoalbuminemia and effects of different albumin levels on the prognosis of surgical septic patients. We preformed a retrospective clinical study including 135 adult patients from September 2011 to June 2014. The albumin levels and severity markers were recorded during the first 48 h after enrollment, and logistic regression analyses were used to determine the risk factors. The outcomes of patients with different albumin levels were also compared. The acute physiology and chronic health evaluation II (APACHE II) score (OR 1.786, 95% CI [1.379-2.314], P < 0.001), C-reactive protein (CRP) (OR 1.016, 95% CI [1.005-1.027], P = 0.005), and blood lactate (OR 1.764, 95% CI [1.141-2.726], P = 0.011) were established as the independent risk factors of hypoalbuminemia in patients with surgical sepsis. The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21-25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis. Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome. In conclusion, APACHE II score (≥14.5), CRP (≥34.25 mg/L), and blood lactate (≥.35 mmol/L) were established as the independent risk factors of hypoalbuminemia in the early stage of surgical sepsis. Patients with baseline albumin level ≤20 g/L had worse prognosis than that of albumin level ≥21 g/L. Albumin levels were negatively correlated the prognosis of surgical sepsis when below about 23 g/L.

No MeSH data available.


Related in: MedlinePlus