scholarly journals Impacts of admission serum albumin levels on short-term and long-term mortality in hospitalized patients

QJM ◽  
2019 ◽  
Vol 113 (6) ◽  
pp. 393-398 ◽  
Author(s):  
C Thongprayoon ◽  
W Cheungpasitporn ◽  
A Chewcharat ◽  
M A Mao ◽  
S Thirunavukkarasu ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Serum Albumin ◽  
Hospital Stay ◽  
Reference Group ◽  
Albumin Level ◽  
Hospitalized Patients ◽  
Tertiary Referral Hospital ◽  
Short And Long Term ◽  
Long Term Mortality

Abstract Aim The aim of this study is to assess the association between admission serum albumin and short- and long-term mortality in all hospitalized patients. Design A single-center cohort study. Methods A retrospective cohort of all adult hospitalized patients at a tertiary referral hospital between January 2009 and December 2013 were analysed. Admission serum albumin was stratified into six groups: ≤2.4, 2.5–2.9, 3.0–3.4, 3.5–3.9, 4.0–4.4 and ≥4.5 g/dl. The outcomes of interest were in-hospital mortality, length of hospital stay and 1-year mortality. Serum albumin of 4–4.4 g/dl was selected as a reference group for outcome comparison. Results A total of 14 075 patients were studied. Admission serum albumin of ≥4.5 g/dl had the lowest in-hospital and 1-year mortality with progressively increased in-hospital mortality observed with decreased admission serum albumin. In adjusted analysis, compared with serum albumin of 4.0–4.4 g/dl, serum albumin of ≤2.4, 2.5–2.9, 3.0–3.4 and 3.5–3.9 were significantly associated with increased in-hospital and 1-year mortality. In contrast, serum albumin of ≥4.5 g/dl was significantly associated with lower 1-year mortality but not in-hospital mortality. Admission serum albumin <4.0 g/dl was significantly associated with a prolonged hospital stay, while admission serum albumin of ≥4.5 g/dl was significantly associated with shorter hospital stay, compared with serum albumin of 4.0–4.4 g/dl. Conclusion Low albumin level at admission was progressively associated with increased short- and long-term mortality in all hospitalized patients even when albumin level was considered in normal range.

Association Between Albumin Level and Mortality Among Cardiac Intensive Care Unit Patients

2020 ◽  
pp. 088506662096387
Author(s):  
Mitchell Padkins ◽  
Thomas Breen ◽  
Nandan Anavekar ◽  
Gregory Barsness ◽  
Kianoush Kashani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Albumin Level ◽  
Post Discharge ◽  
Cardiac Intensive Care Unit ◽  
Short And Long Term ◽  
Cardiac Intensive Care ◽  
Long Term Mortality

Purpose: To study the effect of hypoalbuminemia on short- and long-term mortality in Cardiac Intensive Care Unit (CICU) patients. Methods: We reviewed 12,418 unique CICU patients from 2007 to 2018. Hypoalbuminemia was defined as an admission albumin level <3.5 g/dL. Predictors of hospital mortality were identified using multivariable logistic regression. Results: We included 2,680 patients (22%) with a measured admission albumin level. The median age was 68 (39% females). Admission diagnoses included acute coronary syndrome, heart failure, cardiac arrest, and cardiogenic shock. The median albumin level was 3.4 g/dL and 55% of patients had hypoalbuminemia. Hospital mortality occurred in 16%, and patients with hypoalbuminemia had higher hospital mortality (21% vs. 9%, adjusted OR 2.64, 95% CI 2.09-3.34, p < 0.001). Albumin level was inversely associated with hospital mortality (adjusted OR 0.60 per 1 g/dL higher albumin level, 95% CI 0.47-0.75, p <0.001), with a stepwise increase in the hospital mortality at lower albumin levels. Post-discharge mortality was higher in hospital survivors with hypoalbuminemia, and increased as a function of lower albumin levels. Conclusion: Hypoalbuminemia is common in CICU patients and associated with higher short- and long-term mortality. Progressively lower serum albumin was incrementally associated with higher hospital and post-discharge mortality.

scholarly journals A Retrospective Cohort Study on the Association between Red Cell Distribution Width and All-Cause Mortality of Patients with Cholecystitis at ICU Admission

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Yihua Dong ◽  
Yu Pan ◽  
Wei Zhou ◽  
Yanhuo Xia ◽  
Jingye Pan
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Regression Models ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Prognostic Effect ◽  
Short And Long Term ◽  
Long Term Mortality

Background. Elevated red cell distribution width (RDW) has been reported to be associated with mortality in some critically ill patient populations. The aim of this article is to investigate the relationship between RDW and in-hospital mortality and short- and long-term mortality of patients with cholecystitis. Method. We conducted a retrospective cohort study in which data from all 702 patients extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database were used. Receiver operating characteristic (ROC) curves were constructed to evaluate the prognostic predictive value of RDW for in-hospital mortality and short- (i.e., 30-day and 90-day) and long-term (i.e., 180-day, 1-year, 3-year, and 5-year) mortality. We converted RDW into a categorical variable according to quintiles as less than or equal to 13.9%, 14.0-14.8%, 14.9-15.8%, and 15.9-17.2% and more than 17.2%. The Kaplan-Meier (K-M) methods and log-rank tests were used to compare survival differences among different groups. The relationships between RDW levels and in-hospital mortality were evaluated by univariate and multivariate binary logistic regression models. Multivariable Cox regression models were built to investigate the association of RDW on the short-term and long-term mortality. Result. After adjusting for potential confounders, RDW was positively associated with in-hospital mortality (OR: 1.187, 95% CI [1.049, 1.343]) and short- (i.e., 30-day: HR: 1.183, 95% CI [1.080, 1.295], 90-day: HR: 1.175, 95% CI [1.089, 1.268]) and long-term (i.e., 1-year: HR:1.162, 95% CI [1.089, 1.240]) mortality in critically ill patients with cholecystitis. Similar results were also shown in the secondary outcomes of 180-day, 3-year, and 5-year mortality. RDW had a significant accurate prognostic effect on different endpoints and could improve the prognostic effect of scoring systems. Conclusion. High level of RDW is associated with an increased risk of in-hospital mortality and short- and long-term mortality in critically ill patients with cholecystitis. RDW can independently predict the prognosis of patients with cholecystitis.

scholarly journals Increased mortality risk associated with serum sodium variations and borderline hypo- and hypernatremia in hospitalized adults

2019 ◽  
Vol 35 (10) ◽  
pp. 1746-1752 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
John Q Yap ◽  
Qi Qian
Keyword(s):  
Hospital Stay ◽  
Serum Sodium ◽  
Reference Range ◽  
Length Of Hospital Stay ◽  
Sodium Concentration ◽  
Dependent Manner ◽  
Short And Long Term ◽  
Dose Dependent ◽  
Long Term Mortality

Abstract Background This study aimed to evaluate short-term and long-term mortalities in a cohort of unselected hospitalized patients with serum sodium concentration ([Na+]) variations within and outside of reference range. Methods All adult patients admitted to the Mayo Clinic, Rochester, MN, USA from January 2011 to December 2013 (n = 147358) were retrospectively screened. Unique patients admitted during the study period were examined. The main exposure was serum [Na+] variation. Outcome measures were hospital and 1-year all-cause mortalities. Results A total of 60944 patients, mean age 63 ± 17 years, were studied. On admission, 17% (n = 10066) and 1.4% (n = 852) had hypo- and hypernatremia, respectively. During the hospital stay, 11044 and 4128 developed hypo- and hypernatremia, respectively, accounting for 52.3 and 82.9% of the total hypo- and hypernatremic patients. Serum [Na+] variations of ≥6 mEq/L occurred in 40.6% (n = 24 740) of the 60 944 patients and were significantly associated with hospital and 1-year mortalities after adjusting potential confounders (including demographics, comorbidities, estimated glomerular filtration rate, admission serum [Na+], number of [Na+] measurements and length of hospital stay). Adjusted odds ratios for hospital and 1-year mortalities increased with increasing [Na+] variations in a dose-dependent manner, from 1.47 to 5.48 (all 95% confidence intervals &gt;1.0). Moreover, in fully adjusted models, [Na+] variations (≥6 mEq/L) within the reference range (135–145 mEq/L) or borderline hypo- or hypernatremia (133–137 and 143–147 mEq/L, respectively) compared with 138–142 mEq/L were associated with increased hospital and 1-year mortalities. Conclusion In hospitalized adults, [Na+] fluctuation (≥6 mEq/L) irrespective of admission [Na+] and borderline hypo- or hypernatremia are independent predictors of progressively increasing short- and long-term mortality burdens.

scholarly journals Thyroid Hormones as Predictors of Short- and Long-term Mortality in Very Old Hospitalized Patients

2013 ◽  
Vol 68 (9) ◽  
pp. 1122-1128 ◽  
Author(s):  
W. De Alfieri ◽  
F. Nistico ◽  
T. Borgogni ◽  
F. Riello ◽  
F. Cellai ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Hospitalized Patients ◽  
Very Old ◽  
Short And Long Term ◽  
Long Term Mortality

Prognostic Significance of Serum Albumin in Patients With Acute Coronary Syndrome

Angiology ◽  
2020 ◽  
Vol 71 (10) ◽  
pp. 903-908
Author(s):  
Nihat Polat ◽  
Mustafa Oylumlu ◽  
Mehmet Ali Işik ◽  
Bayram Arslan ◽  
Mehmet Özbek ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Prognostic Significance ◽  
Albumin Level ◽  
Left Ventricular ◽  
Normal Serum ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
Long Term Mortality

In patients with unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI), long-term mortality remains high despite improvements in the diagnosis and treatment. In this study, we investigated whether serum albumin level is a useful predictor of long-term mortality in patients with UAP/NSTEMI. Consecutive patients (n = 403) who were hospitalized with a diagnosis of UAP/NSTEMI were included in the study. Patients were divided into 2 groups based on the presence of hypoalbuminemia and the relationship between hypoalbuminemia and mortality was analyzed. Hypoalbuminemia was detected in 34% of the patients. The median follow-up period was 35 months (up to 45 months). Long-term mortality rate was 32% in the hypoalbuminemia group and 8.6% in the group with normal serum albumin levels ( P < .001). On multivariate analysis, hypoalbuminemia, decreased left ventricular ejection fraction, and increased age were found to be independent predictors of mortality ( P < .05). The cutoff value of 3.10 g/dL for serum albumin predicted mortality with a sensitivity of 74% and specificity of 67% (receiver-operating characteristic area under curve: 0.753, 95% CI: 0.685-0.822). All-cause long-term mortality rates were significantly increased in patients with hypoalbuminemia. On-admission albumin level was an independent predictor of mortality in patients with UAP/NSTEMI.

Abstract WMP90: Race/Ethnic Disparities in Short and Long Term Mortality Among Medicare Beneficiaries in Florida and Puerto Rico: Data from the Florida Puerto Rico Collaboration to Reduce Stroke Disparities (FL-PR CReSD) Study - the NINDS Stroke Prevention Intervention Research Program

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hannah Gardener ◽  
Erica C Leifheit-Limson ◽  
Judith Lichtman ◽  
Yun Wang ◽  
Kefeng Wang ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Hospital Mortality ◽  
Acute Stroke ◽  
Ethnic Disparities ◽  
Stroke Care ◽  
Medicare Beneficiaries ◽  
Acute Stroke Care ◽  
Short And Long Term ◽  
Long Term Mortality

Background: Race/ethnic disparities in acute stroke care may impact stroke outcomes. We compared short- and long-term mortality by race/ethnicity among Medicare beneficiaries in Get With The Guidelines (GWTG) hospitals participating in the NINDS-funded prospective Florida Puerto Rico Collaboration to Reduce Stroke Disparities Registry (GWTG/CReSD), GWTG hospitals not in the Registry (GWTG/non-CReSD), and non-GWTG hospitals not in the Registry (non-GWTG/non-CReSD). Methods: The population included Medicare beneficiaries age 65+ in FL and PR, hospitalized from 2010-2013 with ischemic stroke (ICD-9 433, 434, 436; N=105,205, mean age=80 years, 54% women). We used mixed logistic models adjusted for demographic and clinical characteristics to assess race/ethnic differences in in-hospital, 30-day, and 1-year mortality, stratifying by hospital type (GWTG/CReSD, GWTG/non-CReSD, non-GWTG/non-CReSD). Results: In the 62 GWTG/CReSD hospitals (N=44013, 84% non-Hispanic White (NHW), 9% NH-Black (NHB), 4% FL-Hispanic (FLH), 1% PR-Hispanic (PRH)), NHB had lower 30-day mortality vs NHW (10% vs 12%; OR 0.86, 95% CI 0.77-0.97), but higher 1-year mortality (22% vs 20%; OR 1.13, 95% CI 1.04-1.23); there were no race/ethnic disparities for in-hospital mortality (NHB=6%, NHW=5%, FLH=7%, PRH=12%). However, in 74 GWTG/non-CReSD hospitals (N=46770, 88% NHW, 8% NHB, 2% FLH, 0% PRH), FLH (5%) and NHB (4%) had higher in-hospital mortality vs NHW (3%). For 113 non-GWTG/non-CReSD hospitals (N=14422, 78% NHW, 7% NHB, 5% FLH, 8% PRH), in-hospital mortality was higher for PRH (17%) and NHB (8%) vs NHW (5%). In-hospital and 1-year mortality were lower in CReSD and in GWTG/non-CReSD vs in non-GWTG/non-CReSD hospitals. Conclusions: FL and PR Medicare beneficiaries treated for stroke in GWTG hospitals (both GWTG/CReSD and GWTG/non-CReSD) had lower mortality vs those treated in non-GWTG hospitals; however, there were less race/ethnic disparities in in-hospital mortality for stroke patients treated at GWTG/CReSD hospitals, which are focused on reducing disparities in acute stroke care. Findings underscore the benefits of quality improvement programs, particularly those focusing on race/ethnic disparities.

Hospital mortality and long-term mortality among hospitalized patients with various admission serum ionized calcium levels

2020 ◽  
Vol 132 (4) ◽  
pp. 385-390 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Api Chewcharat ◽  
Michael A. Mao ◽  
Sorkko Thirunavukkarasu ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospitalized Patients ◽  
Ionized Calcium ◽  
Serum Ionized Calcium ◽  
Long Term Mortality

Low serum albumin levels predict short‐ and long‐term mortality risk in patients hospitalised to general surgery wards

2020 ◽  
Vol 50 (8) ◽  
pp. 977-984 ◽  
Author(s):  
Amit Akirov ◽  
Alexander Gorshtein ◽  
Chagit Adler‐Cohen ◽  
Tali Steinmetz ◽  
Tzipora Shochat ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Mortality Risk ◽  
General Surgery ◽  
Short And Long Term ◽  
Low Serum ◽  
Long Term Mortality

scholarly journals Validation of APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed intensive care unit in Poland: a cohort study

2020 ◽  
Author(s):  
Szymon Czajka ◽  
Katarzyna Ziębińska ◽  
Konstanty Marczenko ◽  
Barbara Posmyk ◽  
Anna Szczepańska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Hospital Mortality ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Post Discharge ◽  
Saps Ii ◽  
Apache Iii ◽  
Short And Long Term ◽  
Long Term Mortality

Abstract Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed.Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.78; 95%CI 0.73-0.83), APACHE III (AUC=0.79; 95%CI 0.74-0.84) and SAPS II (AUC=0.79; 95%CI 0.74-0.84); as well as mortality after hospital discharge (p<0.05): APACHE II (AUC=0.71; 95%CI 0.64-0.78), APACHE III (AUC=0.72; 95%CI 0.65-0.78) and SAPS II (AUC=0.69; 95%CI 0.62-0.76), with no statistically significant difference between the scores (p>0.05). The calibration of the scores was good.Conclusions. All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

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