title: Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus.
abstract: BACKGROUND
  This study was designed to investigate the clinical significance of hypoalbuminemia as a marker of severity and mortality in patients with Scrub typhus.
  
  
  METHODS
  The patients with scrub typhus were divided into two groups based on the serum albumin levels; Group I (serum albumin <3.0 g/dL) and Group II (serum albumin >or=3.0 g/dL). The outcome of patients with hypoalbuminemia was compared with that of normoalbuminemia.
  
  
  RESULTS
  Of the total 246 patients who underwent the study, 84 patients (34.1%) were categorized as Group I and 162 patients were (65.9%) as Group II. Group I showed significantly higher incidence of confusion (24.6% vs. 5.3%, p < 0.001), pulmonary edema (15.8% vs. 3.2%, p = 0.002), pleural effusion (22.8% vs. 11.1%, p = 0.03), arrhythmia (12.3% vs. 2.6%, p = 0.008) and non-oliguric acute renal failure (40.4% vs. 11.1%, p < 0.001) compared to group II. Hypoalbuminemic group had a higher APACHE II score (11.37 +/- 5.0 vs. 6.94 +/- 4.2, p < 0.001), longer hospital stay (19.9 +/- 42.1 days vs 7.5 +/- 13.8 days, p = 0.012), and higher hospital cost compared to Group II.
  
  
  CONCLUSIONS
  This study showed hypoalbuminemia in scrub typhus was closely related to the frequency of various complication, longer hospital stay, consequently the higher medical cost, necessitating more efficient management of patients, including medical resources.
authors.affiliation: Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Geumam-dong, Jeonju 561180, Republic of Korea. lcsmd@jbnu.ac.kr
authors.forename: Chang-Seop
authors.initials: CS
authors.lastname: Lee
authors.forename: In-Suk
authors.initials: IS
authors.lastname: Min
authors.forename: Jeong-Hwan
authors.initials: JH
authors.lastname: Hwang
authors.forename: Keun-Sang
authors.initials: KS
authors.lastname: Kwon
authors.forename: Heung-Bum
authors.initials: HB
authors.lastname: Lee
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D003221:Confusion / Q000453:epidemiology; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000453:epidemiology; D011379:Prognosis; D011654:Pulmonary Edema / Q000453:epidemiology; D012612:Scrub Typhus / Q000150:complications* / Q000175:diagnosis*; D016896:Treatment Outcome