title: Hypoalbuminemia and early mortality after lung transplantation: a cohort study.
abstract: Hypoalbuminemia predicts disability and mortality in patients with various illnesses and in the elderly. The association between serum albumin concentration at the time of listing for lung transplantation and the rate of death after lung transplantation is unknown. We examined 6808 adults who underwent lung transplantation in the United States between 2000 and 2008. We used Cox proportional hazard models and generalized additive models to examine multivariable-adjusted associations between serum albumin and the rate of death after transplantation. The median follow-up time was 2.7 years. Those with severe (0.5-2.9 g/dL) and mild hypoalbuminemia (3.0-3.6 g/dL) had posttransplant adjusted mortality rate ratios of 1.35 (95% CI: 1.12-1.62) and 1.15 (95% CI: 1.04-1.27), respectively. For each 0.5 g/dL decrease in serum albumin concentration the 1-year and overall mortality rate ratios were 1.48 (95% CI: 1.21-1.81) and 1.26 (95% CI: 1.11-1.43), respectively. The association between hypoalbuminemia and posttransplant mortality was strongest in recipients with cystic fibrosis and interstitial lung disease. Hypoalbuminemia is an independent risk factor for death after lung transplantation.
authors.affiliation: Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Baldwin
authors.forename: S M
authors.initials: SM
authors.lastname: Arcasoy
authors.forename: A
authors.initials: A
authors.lastname: Shah
authors.forename: P C
authors.initials: PC
authors.lastname: Schulze
authors.forename: J
authors.initials: J
authors.lastname: Sze
authors.forename: J R
authors.initials: JR
authors.lastname: Sonett
authors.forename: D J
authors.initials: DJ
authors.lastname: Lederer
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology* / Q000401:mortality*; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D012709:Serum Albumin / Q000172:deficiency*; D015996:Survival Rate
chemical_list: D012709:Serum Albumin