TY - JOUR
T1 - Serum Hypoalbuminemia Is a Long-Term Prognostic Marker in Medical Hospitalized Patients, Irrespective of the Underlying Disease
AU - Oster, Howard S.
AU - Dolev, Yardenna
AU - Kehat, Orli
AU - Weis-Meilik, Ahuva
AU - Mittelman, Moshe
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Hypoalbuminemia is common in hypoalbuminemia-associated disorders (HAD), e.g., liver and kidney disease. We hypothesize that hospitalized patients with hypoalbuminemia have poor prognosis irrespective of their underlying disease. Records of patients admitted to Medicine (2010–2018), with and without HAD were analyzed, comparing low (<35 g/L) to normal serum albumin. Mann–Whitney and Chi-squared tests were used, and a logistic regression model was applied. Patients: 14,640 were admitted; 9759 were analyzed (2278 hypoalbuminemia: 736 HAD, 1542 non-HAD). All patients, and the subgroups with (as expected) and without HAD had worse outcomes. Specifically, in patients without HAD, those with hypoalbuminemia (n = 1542) vs. normal albumin (n = 6216) were older, had a higher Charlson Comorbidity Index (CCI, 5 vs. 4), longer median hospital stay (5 vs. 4), higher one year re-admission rate (49.9% vs. 39.8%), and one year mortality (48.9% vs. 15.3%, p < 0.001 for all). LR model predicting 3 month, 1 year and 5 year mortality confirmed the predictive power of albumin (1 year: OR = 4.49 for hypoalbuminema, p < 0.01). Hypoalbuminemia portends poor long-term prognosis in hospitalized patients regardless of the underlying disease and could be added to prognostic predictive models.
AB - Hypoalbuminemia is common in hypoalbuminemia-associated disorders (HAD), e.g., liver and kidney disease. We hypothesize that hospitalized patients with hypoalbuminemia have poor prognosis irrespective of their underlying disease. Records of patients admitted to Medicine (2010–2018), with and without HAD were analyzed, comparing low (<35 g/L) to normal serum albumin. Mann–Whitney and Chi-squared tests were used, and a logistic regression model was applied. Patients: 14,640 were admitted; 9759 were analyzed (2278 hypoalbuminemia: 736 HAD, 1542 non-HAD). All patients, and the subgroups with (as expected) and without HAD had worse outcomes. Specifically, in patients without HAD, those with hypoalbuminemia (n = 1542) vs. normal albumin (n = 6216) were older, had a higher Charlson Comorbidity Index (CCI, 5 vs. 4), longer median hospital stay (5 vs. 4), higher one year re-admission rate (49.9% vs. 39.8%), and one year mortality (48.9% vs. 15.3%, p < 0.001 for all). LR model predicting 3 month, 1 year and 5 year mortality confirmed the predictive power of albumin (1 year: OR = 4.49 for hypoalbuminema, p < 0.01). Hypoalbuminemia portends poor long-term prognosis in hospitalized patients regardless of the underlying disease and could be added to prognostic predictive models.
KW - Albumin
KW - Hospitalization
KW - Hypoalbuminemia
KW - Mortality
KW - Predictive model
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85125087563&partnerID=8YFLogxK
U2 - 10.3390/jcm11051207
DO - 10.3390/jcm11051207
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C2 - 35268297
AN - SCOPUS:85125087563
SN - 2077-0383
VL - 11
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 5
M1 - 1207
ER -