Is hypoalbuminemia a predictor marker of mortality?

  • Siti Maemun Prof. Dr. Sulianti Saroso Infectious Disease Hospital, Jakarta
  • Nina Mariana Prof. Dr. Sulianti Saroso Infectious Disease Hospital, Jakarta
  • Surya Otto Wijaya Prof. Dr. Sulianti Saroso Infectious Disease Hospital, Jakarta
  • Dina Oktavia
  • Vivi Lisdawati
  • Rita Rogayah
Keywords: hypoalbuminemia, hospitalized patients, mortality

Abstract

Latar belakang : Hipoalbuminemia pada pasien rawat inap berkaitan dengan prognosis buruk pasien. Penelitian ini, mengidentifikasi bahwa hipoalbuminemia berat pada awal pasien masuk rawat inap sebagai prediktor andalan penanda laboratorium dalam mortalitas.

Metode : Sebuah studi cross sectional pada pasien dewasa dengan hipoalbuminemia (kadar albumin < 3,5 g / dL) pada pasien rawat inap (usia > 18 tahun) pada periode Januari 2013 - Maret 2018. Kami mengevaluasi penanda prediktor kematian. Multivariat dengan regresi logistik diterapkan dalam penelitian ini.

Hasil : Dari 747 hipoalbuminemia pada pasien rawat inap dengan rata-rata kadar albumin  pada awal adalah 2,0 ± 0,6 g / dL. Sebagian besar pasien (83,4%) memiliki kadar albumin ≤ 2,5 g / dL (hipoalbuminemia berat), 16,6 persen memiliki > 2,5 g / dL (hipoalbuminemia ringan-sedang). Kondisi yang mendasari pasien adalah infeksi HIV / AIDS (26,9%) dan sepsis (26,6%). Proporsi multiple komorbiditas pada kelompok hipoalbuminemia berat adalah 55,1 persen Pada kelompok hipoalbuminemia berat terutama untuk kadar albumin 2,01 - 2,5 g / dL, angka mortalitas adalah 28,3 persen. Berdasarkan model regresi logistik akhir, faktor risiko kematian meliputi kadar albumin pada awal dan lama rawat pasien. Mortalitas lebih tinggi pada pasien dengan hipoalbuminemia berat (rasio odds yang disesuaikan 2,91, 95% CI 1,88-4,50) dibandingkan pasien dengan hipoalbuminemia ringan-sedang.

Kesimpulan: Hipoalbuminemia berat pada awal pasien rawat inap sebagai prediktor penanda kematian di rumah sakit. 

Kata kunci: hipoalbuminemia, pasien rawat inap, mortalitas

 

Abstract

Background: Hypoalbuminemia in hospitalized patients has been associated with poor prognosis. In this study, we attempted to identify that severe hypoalbuminemia at baseline in hospitalized patients is a reliable predictor of laboratory marker for mortality.


Methods: A cross sectional study on adults of hypoalbuminemia (albumin level < 3.5 g/dL) in hospitalized patients (aged > 18 years old) in period January 2013 - March 2018. We evaluated the predictor marker of mortality. Multivariate with the logistic regression was applied in this study.


Results: Of the 747 hypoalbuminemia in hospitalized patients with the mean albumin level at baseline was 2.0 ± 0.6 g/dL. Most patients (83.4 %) had less than or equal to 2.5 g/dL albumin level (severe hypoalbuminemia), 16.6 percent had over 2.5 g/dL (mild-moderate hypoalbuminemia). The underlying condition of patients was HIV/AIDS infection (26.9%) and sepsis (26.6 %). The proportion of multiple comorbidities in the severe hypoalbuminemia group was 55.1percent. In the severe hypoalbuminemia group especially for 2.01 – 2.5 g/dL albumin level, the mortality rate was 28.3 percent. Based on the final logistic regression model, known risk factors of mortality include albumin level at baseline and length of stay. Mortality was higher among patients with severe hypoalbuminemia (adjusted odds ratio 2.91, 95 % CI 1.88-4.50) than patients with mild-moderate hypoalbuminemia.


Conclusion: Severe hypoalbuminemia at baseline in the hospitalized patients was a predictor laboratory
marker of hospital mortality. 


Keywords: hypoalbuminemia, hospitalized patients, mortality

References

Char WC, Yih YC, Chin LL, Solomon CC, Yi jen C, Ming SL. Severe hypoalbuminemia is a strong independent risk factor for acute respiratory failure in COPD : a nationwide cohort study. International Journal of COPD, 2015; 10 : 1147-54.

Haroldo F, Andre M. Albumin in critically ill patients : controversies and recommendations. Rev Bras Ter Intensive, 2011; 23; 87-95.

Christoper V, Eleni T, Andrew D, Banwari A. Human albumin solution for patients with cirrhosis and acute on chronic liver failure : beyond simple volume expansion. World J Hepatol, 2016; 8: 345-54.

Vincent JL, Dubois MJ, Navickis RJ, Wilkes MM. Hypoalbuminemia in acute illness: is there a rationale for intervention? a meta-analysis of cohort studies and controlled trials. Ann Surg, 2003: 237(3):319-34.

Chia PC, Wen CF, Cheng TH. Diagnostic performance of initial serum albuminemia level for prediction in hospital mortality among necrotizing fasciitis patients. J.Clin Med, 2018;7:435.

Amit A, Hiba MI, Alaa A, Ilan S. Low albumin levels are associated with mortality risk in hospitalized patients. The American journal of medicine, 2017; 130: 1465.e11-1465.e19.

Ruben Peralta. Hypoalbuminemia [Internet]. https://emedicine.medscape.com/article/166724-overview#a4.

[cited 2018 Dec 3].

Hyosun K, Sion J, Jaebaek L, Young J, Taeoh J, Jaecol Y, et al. Diagnostic performance of initial serum albumin lever for predicting in-hospital mortality among aspiration pneumonia patients. The American Journal of emergency medicine, 2017: 36:5-11.

Juliere L, Marie E, Leah A. Albumin in health and disease : cause and treatment of hypoalbuminemia. International medicine compendium, 2019:12;1-5.

Farzaneh F, Shariar M. Investigating the use of human albumi in a non teaching hospital in Iran. Irian Journal of pharmaceutical research, 2017; 16: 817-22.

Levitt DG, Levitt MD. Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med. 2016;9:229-55. [PMC free article] [PubMed].

Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015 May;81(1):17-27. [PubMed]

Brock F, Bettinelli LA, Dobner T, Stobbe JC, Pomatti G, Telles CT. Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders. Rev Lat Am Enfermagem. 2016 Aug 08;24:e2736. [PMC free article] [PubMed]

Anibal B, Alessandra F, Mayra G, Edson A, Lorena A, Roosevelt S, et al. The use of APACHE II, SOFA, SAPS 3, C reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients : a retrospective cohort study. Medicine. 2019; 98:26.

Lauriane F, Julien B, Marc M, Kossar H, Christine R, Luciane S, et al. Serum albumin or body mass index : which prognostic factor for survival in patients with acute myeloblastic leukaemia ?. Hematol Oncol. 2019; 37:80 4.

Published
2020-12-23
How to Cite
Maemun, S., Mariana, N., Wijaya, S., Oktavia, D., Lisdawati, V., & Rogayah, R. (2020). Is hypoalbuminemia a predictor marker of mortality?. Health Science Journal of Indonesia, 11(2), 121-125. https://doi.org/10.22435/hsji.v11i2.3072
Section
Articles