Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock

Autor: Jantti, T, Tarvasmaki, T, Harjola, VP, Javanainen, T, Tolppanen, H, Hongisto, M, Kataja, A, Banaszewski, M, Kober, L, Lassus, J, Mebazaa, A, Parissis, J, Silva-Cardoso, J, Sionis, A, Di Somma, S, Spinar, J, Koniari, K, Voumvourakis, A, Karavidas, A, Sans-Rosello, J, Vila, M, Duran-Cambra, A, Metra, M, Bulgari, M, Lazzarini, V, Parenica, J, Stipal, R, Ludka, O, Palsuva, M, Ganovska, E, Kubena, P, Lindholm, MG, Hassager, C, Backlund, T, Jurkko, R, Jarvinen, K, Nieminen, T, Pulkki, K, Soininen, L, Sund, R, Tierala, I, Tolonen, J, Varpula, M, Korva, T, Pitkala, A, Marino, R, Sousa, ASC, Paiva, M, Rangel, I, Almeida, R, Pinho, T, Maciel, MJ, Stepinska, J, Skrobisz, A, Goral, P
Rok vydání: 2019
Zdroj: PLoS One
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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ISSN: 1932-6203
Popis: Introduction The prevalence of hypoalbuminemia, early changes of plasma albumin (P-Alb) levels, and their effects on mortality in cardiogenic shock are unknown. Materials and methods P-Alb was measured from serial blood samples in 178 patients from a prospective multinational study on cardiogenic shock. The association of hypoalbuminemia with clinical characteristics and course of hospital stay including treatment and procedures was assessed. The primary outcome was all-cause 90-day mortality. Results Hypoalbuminemia (P-Alb < 34g/L) was very frequent (75%) at baseline in patients with cardiogenic shock. Patients with hypoalbuminemia had higher mortality than patients with normal albumin levels (48% vs. 23%, p = 0.004). Odds ratio for death at 90 days was 2.4 [95% CI 1.5-4.1] per 10 g/L decrease in baseline P-Alb. The association with increased mortality remained independent in regression models adjusted for clinical risk scores developed for cardiogenic shock (CardShock score adjusted odds ratio 2.0 [95% CI 1.1-3.8], IABP-SHOCK II score adjusted odds ratio 2.5 [95% CI 1.2-5.0]) and variables associated with hypoalbuminemia at baseline (adjusted odds ratio 2.9 [95% CI 1.2-7.1]). In serial measurements, albumin levels decreased at a similar rate between 0h and 72h in both survivors and nonsurvivors (Delta P-Alb -4.6 g/L vs. 5.4 g/L, p = 0.5). While the decrease was higher for patients with normal P-Alb at baseline (p
Databáze: OpenAIRE
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