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印度一家三级医疗中心收治患者的血清白蛋白水平与脓毒症之间的关系

The Relationship Between Serum Albumin Levels and Sepsis in Patients Admitted to a Tertiary Care Center in India.

作者信息

Kumar Hemanth G, Kanakaraju Kirubhakaran, Manikandan Vaiera A C, Patel Vishal, Pranay Chittimalla

机构信息

Internal Medicine, Vinayaka Mission's Kirupananda Variyar Medical College and Hospital, Salem, IND.

General Medicine, Vinayaka Mission's Kirupananda Variyar Medical College and Hospital, Salem, IND.

出版信息

Cureus. 2024 Apr 30;16(4):e59424. doi: 10.7759/cureus.59424. eCollection 2024 Apr.

Abstract

Introduction Sepsis poses a significant threat in Indian hospitals, with high mortality rates and complications. This study explores the correlation between serum albumin levels and sepsis outcomes in an intensive care unit (ICU) setting. The challenges of diagnosing tropical infections further complicate sepsis management in India. Methodology A longitudinal study was conducted at Vinayaka Mission's Kirupananda Variyar Medical College and Hospital, Salem, India. Adult patients admitted between July 2020 and March 2021 with sepsis were included. Serum albumin levels, demographic data, and clinical outcomes were analyzed. The study used a convenient sampling technique with a sample size of 102 patients. Results Among the 102 patients in the ICU, 22 have expired and the mortality rate in the study was 21.6%. Hypoalbuminemia was present in 56.9% (n = 58) of the patients. The mortality rate is higher among the sepsis patients with the occurrence of hypoalbuminemia (29.3%) compared to patients without hypoalbuminemia (11.4%) and the difference in proportion between the two groups was statistically significant (p-value = 0.029). The requirement of vasopressor support is higher among sepsis patients with the occurrence of hypoalbuminemia (56.9%) compared to patients without hypoalbuminemia (27.3%). The chi-square test reveals that the difference in proportion between the two groups was statistically significant (p-value = 0.005). No substantial impact on systemic inflammatory response scores, readmission to ICU, or progression to chronic illness was observed based on albumin levels. Conclusion This study underscores the predictive value of hypoalbuminemia in sepsis outcomes. Patients with decreased albumin levels showed higher mortality rates and increased vasopressor usage. While albumin levels did not significantly influence certain parameters, hypoalbuminemia may serve as an indicator of severity and adverse prognosis in sepsis, emphasizing the need for further research and tailored interventions.

摘要

引言

脓毒症在印度医院构成重大威胁,死亡率高且并发症多。本研究探讨了重症监护病房(ICU)环境下血清白蛋白水平与脓毒症预后之间的相关性。热带感染的诊断挑战使印度的脓毒症管理更加复杂。

方法

在印度塞勒姆的维奈亚卡使命基鲁帕南达·瓦里雅医学院和医院进行了一项纵向研究。纳入2020年7月至2021年3月期间因脓毒症入院的成年患者。分析血清白蛋白水平、人口统计学数据和临床结局。该研究采用方便抽样技术,样本量为102例患者。

结果

在ICU的102例患者中,22例死亡,研究中的死亡率为21.6%。56.9%(n = 58)的患者存在低白蛋白血症。发生低白蛋白血症的脓毒症患者的死亡率(29.3%)高于无低白蛋白血症的患者(11.4%),两组之间的比例差异具有统计学意义(p值 = 0.029)。发生低白蛋白血症的脓毒症患者对血管升压药支持的需求(56.9%)高于无低白蛋白血症的患者(27.3%)。卡方检验显示两组之间的比例差异具有统计学意义(p值 = 0.005)。基于白蛋白水平,未观察到对全身炎症反应评分、再次入住ICU或进展为慢性病有实质性影响。

结论

本研究强调了低白蛋白血症对脓毒症预后的预测价值。白蛋白水平降低的患者死亡率更高,血管升压药的使用增加。虽然白蛋白水平对某些参数没有显著影响,但低白蛋白血症可能作为脓毒症严重程度和不良预后的指标,强调需要进一步研究和针对性干预。

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