重症成人入住重症监护病房时的血清白蛋白水平与谵妄持续时间和严重程度。
Serum Albumin Level at Intensive Care Unit Admission and Delirium Duration and Severity in Critically Ill Adults.
机构信息
Rosalyn Chi is a research fellow, Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis.
Anthony J. Perkins is a biostatistician, Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis.
出版信息
Am J Crit Care. 2024 Nov 1;33(6):412-420. doi: 10.4037/ajcc2024650.
BACKGROUND
Hypoalbuminemia has been associated with an increased risk of in-hospital delirium. However, the relationship between serum albumin levels and the duration and severity of delirium is not well defined.
OBJECTIVE
To investigate the relationship between albumin levels and delirium duration and severity.
METHODS
Study data were from a randomized controlled trial involving adult intensive care unit patients (≥ 18 years old) admitted to 3 academic hospitals from 2009 to 2015 who had positive delirium screening results on the Confusion Assessment Method for the Intensive Care Unit-7. Delirium severity was defined by mean Confusion Assessment Method for the Intensive Care Unit-7 scores by day 8. Delirum duration was defined by the number of delirium-free and coma-free days by day 8. Serum albumin levels within 72 hours of intensive care unit admission were collected from electronic medical records.
RESULTS
The study included 237 patients (mean age, 60.3 years; female sex, 52.7%; receiving mechanical ventilation, 59.5%; acute respiratory failure or sepsis, 57.8%). Serum albumin levels were categorized as 3 g/dL or greater (n = 13), 2.5 to 2.99 g/dL (n = 142), and less than 2.5 g/dL (n = 82). After adjustment for demographic and clinical characteristics, no significant associations between albumin levels and delirium duration or severity were found. However, patients with normal albumin levels (≥3 g/dL) had shorter stays than did patients with hypoalbuminemia.
CONCLUSION
In patients with delirium, higher albumin levels were associated with shorter hospital stays but not with delirium duration or severity.
背景
低白蛋白血症与住院期间谵妄的风险增加有关。然而，血清白蛋白水平与谵妄持续时间和严重程度之间的关系尚未明确。
目的
探讨白蛋白水平与谵妄持续时间和严重程度的关系。
方法
研究数据来自一项涉及成人重症监护病房患者（≥18 岁）的随机对照试验，这些患者于 2009 年至 2015 年期间入住 3 所学术医院，在入住重症监护病房的 72 小时内，通过电子病历收集血清白蛋白水平。在入住重症监护病房的 72 小时内，通过电子病历收集血清白蛋白水平。使用第 7 版重症监护谵妄评估方法进行阳性谵妄筛查的患者。第 8 天的平均重症监护谵妄评估方法评分定义为谵妄严重程度。第 8 天的无谵妄和无昏迷天数定义为谵妄持续时间。
结果
该研究共纳入 237 例患者（平均年龄 60.3 岁；女性 52.7%；接受机械通气 59.5%；急性呼吸衰竭或脓毒症 57.8%）。白蛋白水平分为 3 g/dL 或以上（n=13）、2.5 至 2.99 g/dL（n=142）和小于 2.5 g/dL（n=82）。在调整了人口统计学和临床特征后，白蛋白水平与谵妄持续时间或严重程度之间无显著关联。然而，白蛋白水平正常（≥3 g/dL）的患者住院时间短于低白蛋白血症患者。
结论
在谵妄患者中，较高的白蛋白水平与较短的住院时间相关，但与谵妄持续时间或严重程度无关。
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