Yukl Richard L, Bar-Or David, Harris Lisbeth, Shapiro Howard, Winkler James V
Department of Trauma Research, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80110-2795, USA.
J Emerg Med. 2003 Jul;25(1):1-6. doi: 10.1016/s0736-4679(03)00105-7.
Albumin is an abundant plasma protein with multiple physiologic functions, and low serum albumin levels have been associated with increased mortality in hospitalized patients. In a retrospective matched-pair study, we investigated whether emergency department (ED) albumin levels predict delayed mortality for patients initially stabilized after blunt trauma. Fifty-one hospital non-survivors who died more than 24 h after admission to a trauma center ED were matched by Injury Severity Score, type and location of injury, age, and gender with 51 survivors. All patients had serum albumin levels determined upon arrival in the ED. The non-survivors had a significantly lower admission albumin of 3.1 g/dL compared to 3.5 g/dL for survivors. Patients with albumin levels < 3.4 g/dL were 2.5 times more likely to die compared to patients with normal albumin levels. These preliminary results indicate that initial hypoalbuminemia in blunt trauma patients is an independent predictor of delayed mortality, suggesting that these patients require continued clinical vigilance and an aggressive search for evolving complications.
白蛋白是一种具有多种生理功能的丰富血浆蛋白，血清白蛋白水平低与住院患者死亡率增加有关。在一项回顾性配对研究中，我们调查了急诊科（ED）的白蛋白水平是否能预测钝性创伤后最初病情稳定的患者的延迟死亡率。51名在创伤中心急诊科入院24小时后死亡的医院非幸存者，根据损伤严重程度评分、损伤类型和部位、年龄和性别与51名幸存者进行匹配。所有患者在抵达急诊科时均测定了血清白蛋白水平。非幸存者入院时白蛋白水平显著低于幸存者，分别为3.1 g/dL和3.5 g/dL。白蛋白水平<3.4 g/dL的患者死亡可能性是白蛋白水平正常患者的2.5倍。这些初步结果表明，钝性创伤患者最初的低白蛋白血症是延迟死亡率的独立预测因素，这表明这些患者需要持续的临床监测，并积极寻找不断发展的并发症。
