Peng Wang1,2, Yu Zhang1,2, Xing Wang1, Liyuan Peng2, Lu Jia3, Tiangui Li4, Weelic Chong5, Yang Hai6, Chao You1, Fang Fang7. 1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 2. Department of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China. 3. Department of Neurosurgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China. 4. Department of Neurosurgery, West China Longquan Hospital, Sichuan University, Chengdu, Sichuan, China. 5. Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA. 6. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. 7. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. fangfang01@scu.edu.cn.
Abstract
BACKGROUND: Low serum albumin levels have been identified as a predictor of infectious complications in critically ill patients. However, the association in patients with aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. We aimed to evaluate the prognostic value of hypoalbuminemia using blood samples at admission in patients with aSAH. METHODS: In a multicenter observational study of patients with aSAH, serum albumin counts were collected on admission. Hypoalbuminemia was defined as a total albumin level < 35 g/L. Multivariable logistic regression analyses and propensity score matching were performed to obtain the adjusted odds ratios (ORs) with 95% confidence intervals (CI) for the primary outcome of hospital-acquired infections. RESULTS: A total of 5448 patients were included in the observational cohort study. The odds of hospital-acquired infections were significantly higher in patients with albumin levels 30-34.9 g/L (OR 1.62, 95% CI 1.38-1.90), 25-29.9 g/L (OR 1.97, 95% CI 1.54-2.51), and < 24.9 g/L (OR 2.43, 95% CI 1.53-3.86) compared with patients with albumin level ≥ 35 g/L. The odds of hospital-acquired infections with a change in albumin levels from admission to 48-72 h later of lower than - 10 g/L and - 10 to - 5 g/L were 1.67 (95% CI 1.41-1.86) and 1.24 (95% CI 1.05-1.46), respectively, compared with a change in albumin levels of - 5 to 5 g/L. CONCLUSIONS: In this large study of matched patients with aSAH, hypoalbuminemia at admission was associated with hospital-acquired infections. A decrease in serum albumin levels within 72 h of admission was associated with higher hospital-acquired infections.
BACKGROUND: Low serum albumin levels have been identified as a predictor of infectious complications in critically ill patients. However, the association in patients with aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. We aimed to evaluate the prognostic value of hypoalbuminemia using blood samples at admission in patients with aSAH. METHODS: In a multicenter observational study of patients with aSAH, serum albumin counts were collected on admission. Hypoalbuminemia was defined as a total albumin level < 35 g/L. Multivariable logistic regression analyses and propensity score matching were performed to obtain the adjusted odds ratios (ORs) with 95% confidence intervals (CI) for the primary outcome of hospital-acquired infections. RESULTS: A total of 5448 patients were included in the observational cohort study. The odds of hospital-acquired infections were significantly higher in patients with albumin levels 30-34.9 g/L (OR 1.62, 95% CI 1.38-1.90), 25-29.9 g/L (OR 1.97, 95% CI 1.54-2.51), and < 24.9 g/L (OR 2.43, 95% CI 1.53-3.86) compared with patients with albumin level ≥ 35 g/L. The odds of hospital-acquired infections with a change in albumin levels from admission to 48-72 h later of lower than - 10 g/L and - 10 to - 5 g/L were 1.67 (95% CI 1.41-1.86) and 1.24 (95% CI 1.05-1.46), respectively, compared with a change in albumin levels of - 5 to 5 g/L. CONCLUSIONS: In this large study of matched patients with aSAH, hypoalbuminemia at admission was associated with hospital-acquired infections. A decrease in serum albumin levels within 72 h of admission was associated with higher hospital-acquired infections.
Authors: Xue Yang; Lu Wang; Lukai Zheng; Jiongxing Wu; Junfeng Liu; Zilong Hao; Shihong Zhang; Bo Wu; Ming Liu; Deren Wang Journal: Curr Neurovasc Res Date: 2020 Impact factor: 1.990
Authors: E Sander Connolly; Alejandro A Rabinstein; J Ricardo Carhuapoma; Colin P Derdeyn; Jacques Dion; Randall T Higashida; Brian L Hoh; Catherine J Kirkness; Andrew M Naidech; Christopher S Ogilvy; Aman B Patel; B Gregory Thompson; Paul Vespa Journal: Stroke Date: 2012-05-03 Impact factor: 7.914
Authors: Jennifer A Frontera; Andres Fernandez; J Michael Schmidt; Jan Claassen; Katja E Wartenberg; Neeraj Badjatia; Augusto Parra; E Sander Connolly; Stephan A Mayer Journal: Neurosurgery Date: 2008-01 Impact factor: 4.654
Authors: Hormuzdiyar H Dasenbrock; Robert F Rudy; Timothy R Smith; Donovan Guttieres; Kai U Frerichs; William B Gormley; M Ali Aziz-Sultan; Rose Du Journal: World Neurosurg Date: 2015-11-04 Impact factor: 2.104
Authors: Elisa G Bogossian; Laila Attanasio; Jacques Creteur; David Grimaldi; Sophie Schuind; Fabio S Taccone Journal: World Neurosurg Date: 2020-09-28 Impact factor: 2.104