Clinical Epidemiology (Mar 2023)
Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research
Abstract
Yan Cao,1 Yingjie Su,2 Cuirong Guo,2 Liudang He,2 Ning Ding2 1Department of Emergency Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan Province, People’s Republic of China; 2Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan Province, People’s Republic of ChinaCorrespondence: Ning Ding, Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, Hunan, 410004, People’s Republic of China, Tel +86731-8566-7935, Email [email protected]; [email protected]: This study aimed to explore the relationship between albumin level with short- and long-term outcomes in sepsis patients admitted in the intensive care unit (ICU) based on a large public database to provide clinical evidence for physicians to make individualized plans of albumin supplementation.Methods: Sepsis patients admitted in the ICU in MIMIC-IV were included. Different models were performed to investigate the relationships between albumin and mortalities of 28-day, 60-day, 180-day and 1-year. Smooth fitting curves were performed.Results: A total of 5357 sepsis patients were included. Mortalities of 28-day, 60-day, 180-day and 1-year were 29.29% (n = 1569), 33.92% (n = 1817), 36.70% (n = 1966) and 37.71% (n = 2020). In the fully adjusted model (adjusted for all potential confounders), with each 1g/dL increment in albumin level, the risk of mortality in 28-day, 60-day, 180-day and 1-year decreased by 39% (OR = 0.61, 95% CI: 0.54– 0.69), 34% (OR = 0.66, 95% CI: 0.59– 0.73), 33% (OR = 0.67, 95% CI: 0.60– 0.75), and 32% (OR = 0.68, 95% CI: 0.61– 0.76), respectively. The non-linear negative relationships between albumin and clinical outcomes were confirmed by smooth fitting curves. The turning point of albumin level was 2.6g/dL for short- and long-term clinical outcomes. When albumin level ≤ 2.6g/dL, with each 1g/dL increment in albumin level, the risk of mortality in 28-day, 60-day, 180-day and 1-year decreased by 59% (OR = 0.41, 95% CI: 0.32– 0.52), 62% (OR = 0.38, 95% CI: 0.30– 0.48), 65% (OR = 0.35, 95% CI: 0.28– 0.45), and 62% (OR = 0.38, 95% CI: 0.29– 0.48), respectively.Conclusion: Albumin level was associated with short- and long-term outcomes in sepsis. Albumin supplementation might be beneficial for septic patients with serum albumin< 2.6g/dL.Keywords: albumin, mortality, inflammation, sepsis, MIMIC-IV
