Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905.
Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216.
QJM. 2020 Jun 1;113(6):393-398. doi: 10.1093/qjmed/hcz305.
The aim of this study is to assess the association between admission serum albumin and short- and long-term mortality in all hospitalized patients.
A single-center cohort study.
A retrospective cohort of all adult hospitalized patients at a tertiary referral hospital between January 2009 and December 2013 were analysed. Admission serum albumin was stratified into six groups: ≤2.4, 2.5-2.9, 3.0-3.4, 3.5-3.9, 4.0-4.4 and ≥4.5 g/dl. The outcomes of interest were in-hospital mortality, length of hospital stay and 1-year mortality. Serum albumin of 4-4.4 g/dl was selected as a reference group for outcome comparison.
A total of 14 075 patients were studied. Admission serum albumin of ≥4.5 g/dl had the lowest in-hospital and 1-year mortality with progressively increased in-hospital mortality observed with decreased admission serum albumin. In adjusted analysis, compared with serum albumin of 4.0-4.4 g/dl, serum albumin of ≤2.4, 2.5-2.9, 3.0-3.4 and 3.5-3.9 were significantly associated with increased in-hospital and 1-year mortality. In contrast, serum albumin of ≥4.5 g/dl was significantly associated with lower 1-year mortality but not in-hospital mortality. Admission serum albumin <4.0 g/dl was significantly associated with a prolonged hospital stay, while admission serum albumin of ≥4.5 g/dl was significantly associated with shorter hospital stay, compared with serum albumin of 4.0-4.4 g/dl.
Low albumin level at admission was progressively associated with increased short- and long-term mortality in all hospitalized patients even when albumin level was considered in normal range.
本研究旨在评估所有住院患者入院时血清白蛋白与短期和长期死亡率之间的关系。
单中心队列研究。
分析了 2009 年 1 月至 2013 年 12 月期间在一家三级转诊医院住院的所有成年患者的回顾性队列。将入院时的血清白蛋白分为六组：≤2.4、2.5-2.9、3.0-3.4、3.5-3.9、4.0-4.4 和≥4.5 g/dl。研究的主要终点为院内死亡率、住院时间和 1 年死亡率。将血清白蛋白 4-4.4 g/dl 作为参考组进行比较。
共纳入 14075 例患者。血清白蛋白≥4.5 g/dl 的患者院内死亡率和 1 年死亡率最低，随着入院时血清白蛋白水平降低，院内死亡率逐渐升高。在调整分析中，与血清白蛋白 4.0-4.4 g/dl 相比，血清白蛋白≤2.4、2.5-2.9、3.0-3.4 和 3.5-3.9 与院内和 1 年死亡率升高显著相关。相反，血清白蛋白≥4.5 g/dl 与较低的 1 年死亡率相关，但与院内死亡率无关。与血清白蛋白 4.0-4.4 g/dl 相比，入院时血清白蛋白<4.0 g/dl 与住院时间延长显著相关，而血清白蛋白≥4.5 g/dl 与住院时间缩短显著相关。
即使在白蛋白水平正常范围内，入院时的低白蛋白水平与所有住院患者的短期和长期死亡率增加呈逐渐相关。
