Serum albumin concentration and waiting list mortality in idiopathic interstitial pneumonia.
BACKGROUND
Hypoalbuminemia is a reliable predictor of mortality in patients with various illnesses as well as a predictor of disability and mortality in healthy older adults. The association between hypoalbuminemia and mortality in patients with idiopathic interstitial pneumonia remains unknown. The objective of this study was to examine the relationship between serum albumin concentration and mortality in a large cohort of patients with idiopathic interstitial pneumonia listed for lung transplantation.


METHODS
In patients classified as having idiopathic pulmonary fibrosis who were listed for lung transplantation with the United Network for Organ Sharing between January 1, 2004, and December 31, 2006 (n = 1,269), we studied the relationship between serum albumin concentration at the time of listing and mortality while awaiting transplantation.


RESULTS
Lower serum albumin was associated with increased mortality rate. Patients with lower categories of serum albumin had increased mortality rates before and after multivariable adjustment (p value for linear trend < 0.0001). Analysis with serum albumin as a continuous predictor indicated that the mortality rate increased by 54% with each 0.5 g/dL decrease in serum albumin concentration (95% confidence interval, 32 to 79%).


CONCLUSIONS
Lower serum albumin is strongly and independently associated with higher mortality in patients with idiopathic interstitial pneumonia on transplant waiting lists.
Zisman
David A
DA
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA. Electronic address: dzisman@mednet.ucla.edu.
Kawut
Steven M
SM
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
Lederer
David J
DJ
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
Belperio
John A
JA
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
Lynch
Joseph P
JP
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
Schwarz
Marvin I
MI
Department of Medicine, University of Colorado Health Sciences Center, Denver, CO.
Tayek
John A
JA
Department of Internal Medicine, Harbor-UCLA Medical Center, Los Angeles, CA.
Reuben
David B
DB
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
Karlamangla
Arun S
AS
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin