The Effects of Hypoalbuminemia at Admission on Adverse Outcomes in a Tertiary University Based General Surgical Intensive Care Units

Authors

  • Sivaporn Pondeenana Departmemt of Surgery, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
  • Kaweesak Chittawattanarat Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Kamtone Chandacham Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Tidarat Jirapongchareonlap Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Narain Chotiroosniramit Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Tanyong Pipanmekaporn Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Keywords:

Hypoalbuminemia, surgical intensive care unit, mortality, infection, acute kidney injury

Abstract

Background: Although albumin is the marker of nutrition status but the albumin level usually low on acute illness and its level on outcome is controversy. The objective of this study was to determine the effect of serum albumin which on morbidity and mortality in hospitalized surgical patients admitted to general surgical intensive care unit (SICU).

Method: We performed an ambispective cohort study between 2011-2013. All patients who admitted to SICU were enrolled to this observation. The albumin level, severity of disease, type of surgery and demographic data were collected on the SICU admission. The outcomes included the length of mechanical ventilator day, hospital and SICU stay, lung complication, septicemia, urine infection, acute kidney injury, surgical site infection, new-onset upper gastrointestinal hemorrhage, delirium, seizure, myocardial infarction and mortality were recorded at patient discharge. We categorized the patient into two group based on admission albumin level as normal group (≥ 3.5 g/dL) and hypoalbuminemia group (< 3.5 g/dL)

Results: A total of 893 patients were enrolled and analyzed in this study. Of these, the normal and hypoalbuminemia group were 106 (11.9%) and 787 (88.1%) respectively. After adjusted the adverse outcomes by multivariable analysis, the hypoalbuminemia group had significant higher risk of infective complication [Odds ratio (95% confidence interval): 2.68 (1.35 - 5.30); p = 0.005] especially on pulmonary infection [2.08 (1.01 - 4.27); p = 0.046], acute kidney injury [4.06 (1.44 - 11.47), p = 0.008], and mortality [5.92 (2.12 - 16.54); p = 0.001]

Conclusion: The incidence of hypoalbuminemia is common in SICU. The hypoalbuminemia patients increase risk of infective complication especially pulmonary infection, acute kidney injury, and mortality.

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Published

2018-06-30

How to Cite

1.
Pondeenana S, Chittawattanarat K, Chandacham K, Jirapongchareonlap T, Chotiroosniramit N, Pipanmekaporn T. The Effects of Hypoalbuminemia at Admission on Adverse Outcomes in a Tertiary University Based General Surgical Intensive Care Units. Thai J Surg [Internet]. 2018 Jun. 30 [cited 2024 Dec. 23];39(3):81-7. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/221358

Issue

Vol. 39 No. 3 (2018): July - September

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.