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Low Albumin Levels are Associated with Mortality Risk in Hospitalized Patients.
Am J Med. 2017 Aug 09;:
Authors: Akirov A, Iraqi HM, Atamna A, Shimon I
Abstract
AIMS: Investigate the association of albumin levels on admission and change in levels during hospitalization with hospitalization outcomes.
METHODS: Historical prospective data of patients hospitalized between 2011 and 2013. Levels of albumin were classified to marked hypoalbuminemia (<2.5 mg/dL), mild hypoalbuminemia (2.5-3.5 mg/dL), normal albumin (3.5-4.5 mg/dL) and hyperalbuminemia (>4.5 mg/dL). Main outcomes were length of hospitalization, in-hospital and long-term mortality.
RESULTS: The cohort included 30,732 patients (mean age 67±18 years, 51% male). Most patients had normal albumin levels on admission (n=20,124, 65%), 29% of patients had hypoalbuminemia, mostly mild (n=7,334, 24%), and 5% of patients had marked hypoalbuminemia (n=1,436). Hyperalbuminemia on admission was evident in 6% of the patients (n=1,838). Follow-up (median±SD) was 1, 675±325 days. Compared to in-hospital mortality with normal albumin on admission (2%), mortality was higher with mild (12%) and marked hypoalbuminemia (34%) and lower with hyperalbuminemia (0.3%). Mortality rate at the end-of-follow-up was 29% with normal albumin levels, 67% and 83% with mild and marked hypoalbuminemia, respectively. Patients with hyperalbuminemia on admission and before discharge have the best short- and long-term survival. This pattern was similar when analyzed separately in different age groups. In patients with hypoalbuminemia on admission, normalization of albumin levels before discharge was associated with better short- and long-term survival, compared to patients with hypoalbuminemia before discharge.
CONCLUSIONS: Low albumin levels on admission are associated with increased short- and long-term mortality. Normalization of albumin levels before discharge was associated with lower mortality risk, compared to hypoalbuminemia before discharge.
PMID: 28803138 [PubMed - as supplied by publisher]