PURPOSE: To evaluate if the albumin level can be used as a prognostic factor in critically ill patients.
METHODS: Retrospective chart review of patients who were admitted to ICU over 1-year period.They were reviewed for demographics,albumin level on admission,after 48-hours in ICU and the nadir-albumin,mortality&morbidity measures including ICU-length of stay,hospital-length of stay,complications,days on mechanical-ventilation and APACHE-II-score.The association between albumin level on admission as well as 48 hours later with morbidity & mortality was evaluated.
RESULTS: 621 chart were reviewed.357-charts were included in the study.The mortality rate for albumin>3 on admission was 11.6% vs 31.3% for albumin< 3 with(p-value< 0.0001).The mortality rate for admission albumin of>2vs< 2 was18.7%vs42.3%,respectively(p-value < 0.000).When albumin level was checked 48-hours later,the mortality rate for albumin>3 vs < 3 was10.3%vs29.1%,respectively(p-value=0.008),and for the albumin level>2 vs < 2,18.7%vs42.3% (p-value < 0.0001).The mortality rate for the nadir albumin level was 10.9%vs28.8%(p-value=0.008)for albumin>3 and < 3,respectively;and 14%vs38%(p-value< 0.0001)for albumin>2 and < 2,respectively.The difference in morbidities,including the ICU-length of stay and days on mechanical-ventilation for admission albumin of>3 vs< 3 was not statistically-significant.However,the difference in morbidities was statistically very significant when we compared the admission albumin level of >2 vs < 2.For albumin level after 48-hours as well as the nadir albumin level,the morbidities were statistically significantly different when we compared the albumin of>3 vs < 3 and >2 vs < 2.
CONCLUSION: Low albumin level on admission was associated with higher mortality and complication rate,however did not affect the length of ICU stay and days on mechanical-ventilation.The hypoalbuminemia after 48-hours in ICU and the nadir-albumin level on the other hand were associated with not only higher mortality rate,but also higher morbidities including ICU length of stay and days on mechanical ventilation.
CLINICAL IMPLICATIONS: Albumin level in critically ill patients is a powerful marker of severity of illness and can be used as a prognostic factor.
DISCLOSURE: Atousa Tabrizian, No Financial Disclosure Information; No Product/Research Disclosure Information