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J Korean Soc Emerg Med > Volume 33(5); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(5): 448-459.
Effect of albumin on the outcomes in septic patients with hypoalbuminemia in the emergency department: a propensity score-matched retrospective cohort study
Ji Eun Hwang , Jae Hyuk Lee , Joonghee Kim , Inwon Park
Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence  Ji Eun Hwang ,Tel: 031-787-7584, Fax: 031-787-4081, Email: trigonotis6@gmail.com,
Received: October 1, 2021; Revised: October 17, 2021   Accepted: October 18, 2021.  Published online: October 31, 2022.
ABSTRACT
Objective:
A low albumin concentration is known to be associated with poor prognosis in patients with sepsis, but the benefits of albumin administration in these patients are unclear. This study was performed to investigate the effect of albumin administration on the outcomes of patients suffering from sepsis or septic shock.
Method:
This was a retrospective, propensity score-matched cohort study of septic patients with an initial serum albumin level < 3.0 g/dL admitted to the emergency department (ED) of an urban tertiary university hospital. Patients who received 20% albumin within 24 hours of admission to the ED were compared with those who did not. We performed a 1:1 propensity score-matched analysis. The primary outcome was the 28-day mortality rate and the secondary outcomes were the Sequential Organ Failure Assessment (SOFA) score at 24, 48, and 72 hours, the need for mechanical ventilation and renal replacement therapy (RRT), and admission to the intensive care unit (ICU).
Results:
A total of 1,284 patients were included in the study, and the overall mortality rate was 29.4%. After propensity score matching, 192 patients in the albumin group and 192 in the control group were included in the final analysis. There was no significant difference in the 28-day mortality rates. The SOFA scores at 24, 48, and 72 hours were higher in the albumin group than in the control group. The rates of RRT and admission to the ICU were also higher in the albumin group.
Conclusion:
In patients with sepsis and hypoalbuminemia, albumin replacement was not associated with higher 28-day mortality, but was associated with the higher SOFA scores, higher rates of RRT application and admission to the ICU.
Key words: Sepsis; Albumin; Mortality
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