Yao Tongqing, Xi Yinhua, Chen Fei, Lin Hao, Qian Jun, Liu Xuebo
Department of Cardiology, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China.
Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University, China.
Clinics (Sao Paulo). 2025 Apr 24;80:100659. doi: 10.1016/j.clinsp.2025.100659. eCollection 2025.
Heart failure, especially in the elderly, is a growing global issue. This research explores the safety of human albumin infusion in treating heart failure patients with hypoalbuminemia, despite limited clinical data on its use with diuretic therapy.
Data were collected from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which included a cohort of 6094 patients diagnosed with heart failure. Propensity score matching, logistic regression, Kaplan-Meier curves, and Locally Weighted Scatterplot Smoothing (LOWESS) curves were used to examine how albumin administration correlates with different clinical results. The evaluated results comprised in-hospital mortality, cumulative fluid output over 24 hours, Length of Stay in the Intensive Care Unit (ICU LOS), and overall hospitalization duration (hospital LOS).
Infusing albumin was found to be markedly linked with higher in-hospital mortality among heart failure patients whose serum albumin levels were ≤ 2.9 g/dL (p < 0.001). However, no statistically significant correlation was found between the patients with levels > 2.9 g/dL (p = 0.62). Following propensity score matching in the ≤ 2.9 g/dL serum albumin group, albumin infusion was linked to prolonged hospital and ICU stays (p = 0.002, p < 0.001), but showed no significant association with total 24 hour fluid output and 90-day survival (p = 0.173, p = 0.656).
The use of albumin has been linked to increased risk-adjusted mortality during hospitalization, as well as prolonged stays in both hospital and ICU settings for patients with heart failure and low levels of serum albumin. Physicians should exercise caution when considering the administration of albumin in these cases.
心力衰竭，尤其是在老年人中，是一个日益严重的全球性问题。本研究探讨了输注人白蛋白治疗低白蛋白血症心力衰竭患者的安全性，尽管关于其与利尿剂联合使用的临床数据有限。
从重症监护医学信息数据库III（MIMIC-III）收集数据，该数据库包含6094例被诊断为心力衰竭的患者队列。采用倾向评分匹配、逻辑回归、Kaplan-Meier曲线和局部加权散点图平滑（LOWESS）曲线来研究白蛋白给药与不同临床结果之间的相关性。评估结果包括住院死亡率、24小时累计尿量、重症监护病房住院时间（ICU住院时间）和总住院时间（医院住院时间）。
在血清白蛋白水平≤2.9g/dL的心力衰竭患者中，输注白蛋白与较高的住院死亡率显著相关（p<0.001）。然而，在血清白蛋白水平>2.9g/dL的患者中未发现统计学显著相关性（p = 0.62）。在血清白蛋白水平≤2.9g/dL组进行倾向评分匹配后，输注白蛋白与住院和ICU住院时间延长相关（p = 0.002，p<0.001），但与24小时总尿量和90天生存率无显著关联（p = 0.173，p = 0.656）。
白蛋白的使用与住院期间风险调整后死亡率增加以及血清白蛋白水平低的心力衰竭患者在医院和ICU的住院时间延长有关。在这些情况下，医生在考虑给予白蛋白时应谨慎。
