Behrouz Réza, Godoy Daniel A, Topel Christopher Hans, Birnbaum Lee A, Caron Jean-Louis, Grandhi Ramesh, Johnson Jeremiah N, Misra Vivek, Seifi Ali, Urbansky Kathleen, Di Napoli Mario
Division of Cerebrovascular Diseases, Department of Neurology, School of Medicine, Medical Arts & Research Center, University of Texas Health Science Center, 8300 Floyd Curl Drive, MC 7883, San Antonio, TX, 78229, USA.
The Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina.
Neurocrit Care. 2016 Oct;25(2):230-6. doi: 10.1007/s12028-016-0259-5.
Hypoalbuminemia has been identified as a predictor of morbidity and mortality in critically ill patients. There is very little data on the significance and the prognostic value of hypoalbuminemia in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study analyzed the impact of hypoalbuminemia on patient presentation, complications, and outcomes.
Records of patients admitted with aSAH were examined. Data on baseline characteristics, prevalence of delayed cerebral ischemia, and discharge outcomes were collected. Multivariable logistic regression analysis was performed to assess for associations.
One-hundred and forty-two patients comprised the study cohort (mean age 54.6 ± 13.4), among which 45 (31.5 %) presented with hypoalbuminemia. No difference in baseline characteristics was noted between patients with hypoalbuminemia and those with normal serum albumin. The overall hospital mortality rate was significantly higher in patients with hypoalbuminemia, compared to those with normal albumin (28.9 % vs. 11.3 %; p = 0.04). Hypoalbuminemia was neither associated with delayed cerebral ischemia nor disability at discharge, but independently associated with in-hospital death (odds ratio: 4.26, 95 % confidence interval: 1.09-16.68; p = 0.04).
In patients with aSAH, early hypoalbuminemia is an independent predictor of hospital mortality but not disability at discharge.
低白蛋白血症已被确认为危重症患者发病和死亡的预测指标。关于动脉瘤性蛛网膜下腔出血（aSAH）患者低白蛋白血症的意义和预后价值的数据非常少。本研究分析了低白蛋白血症对患者临床表现、并发症及预后的影响。
检查aSAH入院患者的记录。收集基线特征、迟发性脑缺血患病率及出院结局的数据。进行多变量逻辑回归分析以评估相关性。
142例患者组成研究队列（平均年龄54.6±13.4岁），其中45例（31.5%）出现低白蛋白血症。低白蛋白血症患者与血清白蛋白正常的患者在基线特征上无差异。与白蛋白正常的患者相比，低白蛋白血症患者的总体医院死亡率显著更高（28.9%对11.3%；p=0.04）。低白蛋白血症既与迟发性脑缺血无关，也与出院时的残疾无关，但与院内死亡独立相关（比值比：4.26，95%置信区间：1.09-16.68；p=0.04）。
在aSAH患者中，早期低白蛋白血症是医院死亡率的独立预测指标，但不是出院时残疾的预测指标。
