Thongprayoon C, Cheungpasitporn W, Chewcharat A, Mao MA, Thirunavukkarasu S, Kashani KB. Impacts of admission serum albumin levels on short-term and long-term mortality in hospitalized patients.
QJM 2020;
113:393-398. [PMID:
31747010 DOI:
10.1093/qjmed/hcz305]
[Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/19/2019] [Indexed: 12/14/2022] Open
Abstract
AIM
The aim of this study is to assess the association between admission serum albumin and short- and long-term mortality in all hospitalized patients.
DESIGN
A single-center cohort study.
METHODS
A retrospective cohort of all adult hospitalized patients at a tertiary referral hospital between January 2009 and December 2013 were analysed. Admission serum albumin was stratified into six groups: ≤2.4, 2.5-2.9, 3.0-3.4, 3.5-3.9, 4.0-4.4 and ≥4.5 g/dl. The outcomes of interest were in-hospital mortality, length of hospital stay and 1-year mortality. Serum albumin of 4-4.4 g/dl was selected as a reference group for outcome comparison.
RESULTS
A total of 14 075 patients were studied. Admission serum albumin of ≥4.5 g/dl had the lowest in-hospital and 1-year mortality with progressively increased in-hospital mortality observed with decreased admission serum albumin. In adjusted analysis, compared with serum albumin of 4.0-4.4 g/dl, serum albumin of ≤2.4, 2.5-2.9, 3.0-3.4 and 3.5-3.9 were significantly associated with increased in-hospital and 1-year mortality. In contrast, serum albumin of ≥4.5 g/dl was significantly associated with lower 1-year mortality but not in-hospital mortality. Admission serum albumin <4.0 g/dl was significantly associated with a prolonged hospital stay, while admission serum albumin of ≥4.5 g/dl was significantly associated with shorter hospital stay, compared with serum albumin of 4.0-4.4 g/dl.
CONCLUSION
Low albumin level at admission was progressively associated with increased short- and long-term mortality in all hospitalized patients even when albumin level was considered in normal range.
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