Serum Hypoalbuminemia Is a Long-Term Prognostic Marker in Medical Hospitalized Patients, Irrespective of the Underlying Disease

Howard S. Oster, Yardenna Dolev, Orli Kehat, Ahuva Weis-Meilik, Moshe Mittelman

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number1207
JournalJournal of Clinical Medicine
Volume11
Issue number5
DOIs
StatePublished - 1 Mar 2022

Keywords

  • Albumin
  • Hospitalization
  • Hypoalbuminemia
  • Mortality
  • Predictive model
  • Prognosis

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