title: Human albumin use at hospitals in the Metropolitan Region of Rio de Janeiro, Brazil.
abstract: The study analyzes the use of human albumin in hospitals in Rio de Janeiro, Brazil, using inpatient data from the information system of Brazil's health system between 1999 and 2001. Death was the main outcome as patients died in 32% of admissions in which human albumin was used as compared with 4% of all admissions in the same period and region. The Charlson Comorbidity Index was included for risk adjustment. Human albumin was used in 10,111 in-patients more than 1 year old. 87,774 50-ml bottles of 20% human albumin were consumed at a cost of US$ 1,755. The main diagnoses were neoplasms (29.1%), diseases of the digestive system (17.5%) and circulatory system (16%). Death rate increased with age, public ownership of the hospital, clinical services (as opposed to surgical services), length of stay and use of intensive care. Death was associated with use of more than four bottles of human albumin (PR: 1.30; 99%CI: 1.23-1.37), adjusted for severity and speciality. The results are cause for concern as they may be related to poor compliance with guidelines, excess of risk to patients and unnecessary expenses for the public health system.
authors.affiliation: Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Rocco 255, Rio de Janeiro, RJ, Brazil. guacira@pharma.ufrj.br
authors.forename: Guacira Corrêa de
authors.initials: GC
authors.lastname: Matos
authors.forename: Suely
authors.initials: S
authors.lastname: Rozenfeld
authors.forename: Monica
authors.initials: M
authors.lastname: Martins
mesh_terms: D001938:Brazil / Q000453:epidemiology; D006751:Hospital Information Systems; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D012709:Serum Albumin / Q000008:administration & dosage* / Q000191:economics; D012720:Severity of Illness Index; D014505:Urban Population
chemical_list: D012709:Serum Albumin