O21 Is hypoalbuminaemia associated with amputation-free survival in chronic limb-threatening ischaemia? A retrospective cohort study

Autor:	Rob D. Sayers, I Black, John S.M. Houghton, Andrew T.O. Nickinson
Rok vydání:	2021
Předmět:	medicine.medical_specialty biology business.industry medicine.medical_treatment Ischemia Serum albumin Retrospective cohort study Nutritional status medicine.disease Comorbidity Amputation free survival Amputation Internal medicine medicine biology.protein Surgery Hypoalbuminemia business
Zdroj:	British Journal of Surgery. 108
ISSN:	1365-2168 0007-1323
DOI:	10.1093/bjs/znab282.026
Popis:	Introduction Serum albumin is a recognised marker of nutritional status. Whilst associated with post-operative outcomes, the relationship with amputation-related outcomes in chronic limb-threatening ischaemia (CLTI) remains unclear. It is also uncertain whether any relationship may be confounded by systematic inflammation. We aimed to investigate whether hypoalbuminaemia is associated with amputation-related outcomes and evaluate its relationship with other inflammatory markers. Method A retrospective study of patients managed for CLTI at a vascular centre between 01/01/2013–31/12/2015 was undertaken. Patients were identified from local coding databases. Patient demographics and comorbidities, results of admission bloods and procedural data were recorded from electronic records. Hypoalbuminaemia was defined as albumin concentration Result 374 patients were included (mean albumin concentration = 38.8g/L [SD = 5.2]), with 72 patients being hypoalbuminaemic. No differences were observed in sex (P=0.678), age (P=0.207), history of tissue loss (P=0.057), or cardiovascular comorbidities between groups, however a greater proportion of patients with hypoalbuminaemia had COPD (P=0.002). Patients with hypoalbuminaemia had a significantly higher combined risk of 1-year amputation/death compared to those with normal albumin concentration (HR 1.94, 95% CI 1.29–2.91). White cell count and CRP concentration were significant predictors of albumin concentration (r2=0.113, P Conclusion Hypoalbuminaemia is an important prognostic biomarker of AFS in CLTI, however this association may relate to a complex relationship between nutritional status and inflammation. Take-home Message Albumin is more than just a marker of nutritional status in patients with chronic limb-threatening ischaemia.
Databáze:	OpenAIRE
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