College of Medical Sciences Teaching Hospital, Kathmandu University, Bharatpur, Nepal.
Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Medicine (Baltimore). 2023 Nov 10;102(45):e35979. doi: 10.1097/MD.0000000000035979.
Critical illness is a severe condition that poses a significant threat to multiple organ systems and can lead to substantial morbidity and mortality. Serum albumin concentration can serve as an independent predictor of mortality risk in critically ill patients. This study aimed to determine the role of serial monitoring of serum albumin (SA) levels as a prognostic marker of mortality and morbidity. This observational prospective study was conducted at a tertiary hospital over a period from January 1, 2020, to December 31, 2020, among critically ill patients admitted to the intensive care unit. Data collection was performed using a prestructured proforma. Statistical analysis was carried out using Statistical Package for the Social Sciences software version 23, employing appropriate tests. The P-value <.05 was considered statistically significant. The study included 78 patients with 59 (75.6%) were survivors, and 19 (24.4%) were non-survivors. Mean SA levels did not significantly differ between non-survivors (3.30 ± 0.40 g/dL) and survivors (3.42 ± 0.35 g/dL) on admission (day 1) (P = .234). However, on day 3, non-survivors had significantly lower levels (3.02 ± 0.46 g/dL) compared to survivors (3.31 ± 0.29 g/dL) (P = .001). This trend continued on day 5, with non-survivors having significantly lower levels (2.92 ± 0.30 g/dL) compared to survivors (3.31 ± 0.33 g/dL) (P = .003). The decline in SA levels from day 1 to day 3 and from day 1 to day 5 was statistically significant in non-survivors (P = .001). In survivors, a significant decline was observed from day 1 to day 3 (P = .019), while the decline from day 1 to day 5 was not statistically significant (P = .074). Serial estimation of SA levels in critically ill patients can serve as a valuable prognostic marker, aiding in the identification of individuals at a higher risk of mortality and morbidity.
危重病是一种严重的疾病,对多个器官系统构成重大威胁,并可能导致大量发病率和死亡率。血清白蛋白浓度可作为危重病患者死亡风险的独立预测因子。本研究旨在确定连续监测血清白蛋白(SA)水平作为死亡率和发病率的预后标志物的作用。这项观察性前瞻性研究于 2020 年 1 月 1 日至 2020 年 12 月 31 日在一家三级医院进行,纳入了入住重症监护病房的危重病患者。使用预结构化表格进行数据收集。使用社会科学统计软件包版本 23 进行统计分析,采用适当的检验。P 值<.05 被认为具有统计学意义。该研究纳入了 78 名患者,其中 59 名(75.6%)为幸存者,19 名(24.4%)为非幸存者。非幸存者(3.30±0.40 g/dL)和幸存者(3.42±0.35 g/dL)入院(第 1 天)时的平均 SA 水平无显著差异(P=0.234)。然而,在第 3 天,非幸存者的水平明显较低(3.02±0.46 g/dL),而幸存者(3.31±0.29 g/dL)(P=0.001)。这种趋势在第 5 天持续存在,非幸存者的水平明显低于幸存者(2.92±0.30 g/dL)(P=0.003)。从第 1 天到第 3 天以及从第 1 天到第 5 天,SA 水平的下降在非幸存者中具有统计学意义(P=0.001)。在幸存者中,从第 1 天到第 3 天观察到显著下降(P=0.019),而从第 1 天到第 5 天的下降无统计学意义(P=0.074)。连续估计危重病患者的 SA 水平可以作为一种有价值的预后标志物,有助于识别死亡率和发病率较高的个体。