Effect of Preoperative Albumin Levels on Outcomes in Patients Undergoing Left Ventricular Device Implantation.
Hypoalbuminemia is a well-known predictor of morbidity and mortality in cardiac surgery. Our aim was to establish the impact of serum albumin on outcomes after left ventricular assist device (LVAD) implantation. This was a single-institution retrospective review, including all patients who underwent LVAD implantation between March 2006 and June 2014. Two hundred patients were included in the analysis. Mean serum albumin was 3.27 ± 0.47 g/dl, with 7% in the low albumin group (<2.5 mg/dl), 67.5% in the mid-range (2.5-3.5 mg/dl), and 25.5% in the normal albumin groups (> 3.5 mg/dl). Lower albumin was associated with a significant increase in postoperative renal failure (42.9 vs. 16.5 vs. 17.3%; p = 0.05) and prolonged hospitalization (median 28.5 vs. 16 vs. 15.5 days; p = 0.008). Six month, 1 year, and 5 year survival was 79%, 79%, and 49% with low, 84%, 78%, and 51% with mid-range, and 94%, 88%, and 60% with normal albumin, respectively (p = 0.22). Preoperative hypoalbuminemia is associated with postoperative acute renal failure (ARF) and prolonged hospitalization after LVAD implantation, with no effect on overall survival. Hypoalbuminemia is most likely a marker of advanced disease and should not, in itself, be considered a contraindication to LVAD candidacy.
From the *Division of Cardiothoracic Surgery, and †Department of Cardiovascular Medicine, Henry Ford Hospital, Heart and Vascular Institute, Detroit, Michigan.
Pauline H
PH
Go
Arielle
A
Hodari
Hassan W
HW
Nemeh
Jamil
J
Borgi
David E
DE
Lanfear
Celeste T
CT
Williams
Gaetano
G
Paone
Jeffrey A
JA
Morgan
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood; D049528:Insulin, Long-Acting / Q000097:blood*; D061386:Insulin, Regular, Human / Q000097:blood*; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D012189:Retrospective Studies; D012709:Serum Albumin; D000075462:Serum Albumin, Human; D016896:Treatment Outcome; D055815:Young Adult
C499251:Albulin; D049528:Insulin, Long-Acting; D061386:Insulin, Regular, Human; D012709:Serum Albumin; D000075462:Serum Albumin, Human