title: Risk factors and prognosis of hypoalbuminemia in surgical septic patients.
abstract: The aim of this study was to investigate the risk factors of hypoalbuminemia and effects of different albumin levels on the prognosis of surgical septic patients. We preformed a retrospective clinical study including 135 adult patients from September 2011 to June 2014. The albumin levels and severity markers were recorded during the first 48 h after enrollment, and logistic regression analyses were used to determine the risk factors. The outcomes of patients with different albumin levels were also compared. The acute physiology and chronic health evaluation II (APACHE II) score (OR 1.786, 95% CI [1.379-2.314], P < 0.001), C-reactive protein (CRP) (OR 1.016, 95% CI [1.005-1.027], P = 0.005), and blood lactate (OR 1.764, 95% CI [1.141-2.726], P = 0.011) were established as the independent risk factors of hypoalbuminemia in patients with surgical sepsis. The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21-25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis. Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome. In conclusion, APACHE II score (≥14.5), CRP (≥34.25 mg/L), and blood lactate (≥.35 mmol/L) were established as the independent risk factors of hypoalbuminemia in the early stage of surgical sepsis. Patients with baseline albumin level ≤20 g/L had worse prognosis than that of albumin level ≥21 g/L. Albumin levels were negatively correlated the prognosis of surgical sepsis when below about 23 g/L.
authors.affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.
authors.forename: Jia-Kui
authors.initials: JK
authors.lastname: Sun
authors.affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.
authors.forename: Fang
authors.initials: F
authors.lastname: Sun
authors.affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.
authors.forename: Shou-Tao
authors.initials: ST
authors.lastname: Yuan
authors.affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.
authors.forename: Shu-Yun
authors.initials: SY
authors.lastname: Zheng
authors.affiliation: Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu Province , China.
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Mu
keywords: Hypoalbuminemia; Prognosis; Risk factor; Sepsis; Septic shock