Serum Serial Albumin as a Prognostic Marker in Critically Ill Patients
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 2
Abstract
Introduction: Serum albumin (SA) is a useful marker of nutritional status of an individual. It serves as an indicator of overall clinical status in critically ill (CI) patients. Hypoalbuminemia is associated with increased mortality and morbidity in critical illness. It is a cheap and effective way to stratify the patients and take required emergency measures. The aim of the study is to determine the correlation between daily SA levels, mortality and clinical status of CI patients. Materials and Methods: CI patients were defined as those who either had multi-organ dysfunction and/or sepsis and required intensive care. The patients with chronic liver and kidney disease were excluded from the study. Comparison and trend of SA over first 5 days of admission were studied among survivors (S) and non-survivors (NS) irrespective of diagnosis. Observations: A significant difference (P < 0.05) was observed in the mean SA on day 3 between S and NS (2.89 and 2.55 g/dl, respectively). Among the S, those with higher mean SA of on day 3 had shorter hospital stay (≤7 days, Group 1) compared to those with >7 days (Group 2) (mean SA 3.17 g/dl [2.54-3.78] and 2.77 g/dl [2.21-3.31], respectively) (P < 0.05). SA on day 1 (3.34 ± 0.68 g/dl) compared with SA on day 5 (3.77 ± 0.70 g/dl) in Group 1, showed an increasing trend which reached statistical significance (P = 0.05) whereas in Group 2, SA on day 1 when matched with SA on day 5, rise was in significant (3.14, 3.28 g/dl, P > 0.05, respectively). Those who recovered to higher SA value on day 5 had higher chances of survival (SA <2.5 g/dl - 70% mortality). Conclusion: SA on day 3 correlated directly with higher mortality in CI patients. Day 3 SA and the level of change, during the hospital stay, had an impact on morbidity. Day 5 SA <2.5 g/dl served as a poor prognostic marker. SA thus serves as a simple but powerful prognostic tool for CI patients.
Authors and Affiliations
A Pal, Akanksha Jain, M K Parashar
Keywords
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