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Neurocrit Care. 2016 Oct;25(2):230-6. doi: 10.1007/s12028-016-0259-5.

Early Hypoalbuminemia is an Independent Predictor of Mortality in Aneurysmal Subarachnoid Hemorrhage.

Author information

1
Division of Cerebrovascular Diseases, Department of Neurology, School of Medicine, Medical Arts & Research Center, University of Texas Health Science Center, 8300 Floyd Curl Drive, MC 7883, San Antonio, TX, 78229, USA. behrouz@uthscsa.edu.
2
The Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina.
3
Division of Cerebrovascular Diseases, Department of Neurology, School of Medicine, Medical Arts & Research Center, University of Texas Health Science Center, 8300 Floyd Curl Drive, MC 7883, San Antonio, TX, 78229, USA.
4
Department of Neurological Surgery, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
5
Department of Medical Informatics, University Hospital, San Antonio, TX, USA.
6
Neurological Service, San Camillo de' Lellis General Hospital, Rieti, Italy.
7
Neurological Section, SMDN-Center for Cardiovascular Medicine and Cerebrovascular Disease, Sulmona, L'Aquila, Italy.

Abstract

BACKGROUND:

Hypoalbuminemia has been identified as a predictor of morbidity and mortality in critically ill patients. There is very little data on the significance and the prognostic value of hypoalbuminemia in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study analyzed the impact of hypoalbuminemia on patient presentation, complications, and outcomes.

METHODS:

Records of patients admitted with aSAH were examined. Data on baseline characteristics, prevalence of delayed cerebral ischemia, and discharge outcomes were collected. Multivariable logistic regression analysis was performed to assess for associations.

RESULTS:

One-hundred and forty-two patients comprised the study cohort (mean age 54.6 ± 13.4), among which 45 (31.5 %) presented with hypoalbuminemia. No difference in baseline characteristics was noted between patients with hypoalbuminemia and those with normal serum albumin. The overall hospital mortality rate was significantly higher in patients with hypoalbuminemia, compared to those with normal albumin (28.9 % vs. 11.3 %; p = 0.04). Hypoalbuminemia was neither associated with delayed cerebral ischemia nor disability at discharge, but independently associated with in-hospital death (odds ratio: 4.26, 95 % confidence interval: 1.09-16.68; p = 0.04).

CONCLUSION:

In patients with aSAH, early hypoalbuminemia is an independent predictor of hospital mortality but not disability at discharge.

KEYWORDS:

Albumin; Critical are; Hypoalbuminemia; Subarachnoid hemorrhage

PMID:
26920908
DOI:
10.1007/s12028-016-0259-5
[Indexed for MEDLINE]

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