title: Use of albumin as a risk factor for hospital mortality among burn patients in Brazil: non-concurrent cohort study.
abstract: OBJECTIVE
  among burn patients, it is common to use colloidal substances under the justification that it is necessary to correct the oncotic pressure of the plasma, thereby reducing the edema in the burnt area and the hypotension. The aim here was to assess the risk of hospital mortality, comparing the use of albumin and crystalloid solutions for these patients.
  
  
  METHODS
  non-concurrent historical cohort study at Faculdade de Medicina de Marília; within the Postgraduate program on Internal and Therapeutic Medicine, Universidade Federal de São Paulo; and at the Brazilian Cochrane Center.
  
  
  METHODS
  burn patients hospitalized between 2000 and 2001, with registration in the Hospital Information System, who received albumin, were compared with those who received other types of volume replacement. The primary outcome was the hospital mortality rate. The data were collected from files within the Datasus software.
  
  
  RESULTS
  39,684 patients were included: 24,116 patients with moderate burns and 15,566 patients with major burns. Among the men treated with albumin, the odds ratio for the risk of death was 20.58 (95% confidence interval, CI: 11.28-37.54) for moderate burns and 6.24 (CI 5.22-7.45) for major burns. Among the women, this risk was 40.97 for moderate burns (CI 21.71-77.30) and 7.35 for major burns (CI 5.99-9.01). The strength of the association between the use of albumin and the risk of death was maintained for the other characteristics studied, with statistical significance.
  
  
  CONCLUSIONS
  the use of albumin among patients with moderate and major burns was associated with considerably increased mortality.
authors.affiliation: Faculdade de Medicina de Marília, Marília, São Paulo, Brazil.
authors.forename: Gilson
authors.initials: G
authors.lastname: Caleman
authors.forename: José Fausto de
authors.initials: JF
authors.lastname: Morais
authors.forename: Maria Eduarda Dos Santos
authors.initials: ME
authors.lastname: Puga
authors.forename: Rachel
authors.initials: R
authors.lastname: Riera
authors.forename: Alvaro Nagib
authors.initials: AN
authors.lastname: Atallah
mesh_terms: D000328:Adult; D000418:Albumins / Q000009:adverse effects*; D001938:Brazil / Q000453:epidemiology; D002056:Burns / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D000077324:Crystalloid Solutions; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007552:Isotonic Solutions / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000009:adverse effects*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000418:Albumins; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes