2019, Number 5
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Cir Cir 2019; 87 (5)
Is albumin a predictor of severity and mortality in patients with abdominal sepsis?
Godinez-Vidal AR, Correa-Montoya A, Enríquez-Santos D, Pérez-Escobedo SU, López-Romero SC, Gracida-Mancilla NI
Language: Spanish
References: 25
Page: 485-489
PDF size: 254.21 Kb.
ABSTRACT
Background: Patients with a lower level of albumin have a more severe infection, the level of said biomarker is a strong
predictor of mortality.
Objective: To determine the usefulness of the serum albumin level as a predictor of severity and mortality.
Methods: Retrospective, descriptive, cross-sectional study of patients diagnosed with abdominal sepsis. During the
period from April 2016-February 2017. The severity was determined by Acute Physiology and Chronic Health Evaluation
(APACHE) II, Sequential Organ Failure Assessment (SOFA), Mannheim and mortality. The sample was divided into those with
albumin › 2.9 mg/dl and ‹ 2.8 mg/dl.
Results: We included 155 cases, 62 female and 93 male; the main organ causing
abdominal sepsis was the appendix 42%. The average albumin for the sample was 3.2 mg/dl (DE ± 0.9). The findings, subjected
to statistical verification by means of the Mann-Whitney test, showed statistical significance among the cases with
albumin ‹ 2.8 mg/dl with those have ranged Mannheim › 26 points (p = 0.001), APACHE › 15 (p = 0.015) and SOFA › 6
(p = 0.001), No statistical significance was obtained between albumin level ‹ 2.8, and mortality (p = 0.052).
Conclusion: Albumin
can be considered as a predictor of severity, although not as a predictor of mortality.
REFERENCES
Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303-10.
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. SCCM/ESICM/ACCP/ATS/SIS. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31:1250-6.
Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, et al. Sepsis Occurrence in Acutely Ill Patients Investigators. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34:344-53.
Nguyen HB, Rivers EP, Abrahamian FM, Moran GJ, Abraham E, Trzeciak S, et al. Severe sepsis and septic shock: review of the literature and emergency department management guidelines. Ann Emerg Med. 2006;48:28-54.
Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med. 2003;348:138-50.
Gullo A, Bianco N, Berlot G. Management of severe sepsis and septic shock: challenges and recommendations. Crit Care Clin. 2006;22:489-501.
Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69:89-95.
Marshall JC, Reinhart K. Biomarkers of sepsis. Crit Care Med. 2009;37:2290-8.
Taverna M, Marie AL, Mira JP, Guidet B. Specific antioxidant properties of human serum albumin. Ann Intensive Care. 2013;3:4.
Antonelli M, Maggiore SM. Consensus statement of the ESICM task force on colloid volume therapy in critically ill patients. Intensive Care Med. 2012;38:1560.
SAFE Study Investigators; Finfer S, Bellomo R, McEvoy S, Lo SK, Myburgh J, et al. Effect of baseline serum albumin concentration on outcome of resuscitation with albumin or saline in patients in intensive care units: analysis of data from the saline versus albumin fluid evaluation (SAFE) study. BMJ. 2006;333:1044.
Brun-Buisson C, Doyon F, Carlet J, Dellamonica P, Gouin F, Lepoutre A, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA. 1995;274:968-74.
Ballmer-Weber BK, Dummer R, Kung E, Burg G, Ballmer PE. Interleukin 2-induced increase of vascular permeability without decrease of the intravascular albumin pool. Br J Cancer. 1995;71:78-82.
Doweiko JP, Nompleggi DJ. The role of albumin in human physiology and pathophysiology, part III: albumin and disease states. JPEN J Parenter Enteral Nutr. 1991;15:476-83.
Fleck A, Raines G, Hawker F, Trotter J, Wallace PI, Ledingham IM, et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet. 1985;1:781-4.
Demling RH. Effect of plasma and interstitial protein content on tissue edema formation. Curr Stud Hematol Blood Transfus. 1986;(53):36-52.
Sitar ME, Aydin S, Cakatay U. Human serum albumin and its relation with oxidative stress. Clin Lab. 2013;59:945-52.
Brown JM, Beehler CJ, Berger EM, Grosso MA, Whitman GJ, Terada LS, et al. Albumin decreases hydrogen peroxide and reperfusion injury in isolated rat hearts. Inflammation. 1989;13:583-9.
Tamion F. Albumin in sepsis. Ann Fr Anesth Reanim. 2010;29:629-34.
Volakli E, Spies C, Michalopoulos A, Groeneveld AB, Sakr Y, Vincent JL. Infections of respiratory or abdominal origin in ICU patients: what are the differences? Crit Care. 2010;14:R32.
Mohri Y, Inoue Y, Tanaka K, Hiro J, Uchida K, Kusunoki M. Prognostic nutritional index predicts postoperative outcome in colorectal cáncer. World J Surg. 2013;37:2688-92.
Artero A, Zaragoza R, Camarena JJ, Sancho S, González R, Nogueira JM. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock. J Crit Care. 2010;25:276-81.
Qian SY, Liu J. Relationship between serum albumin level and prognosis in children with sepsis, severe sepsis or septic shock. Zhonghua Er Ke Za Zhi. 2012;50:184-7.
Yin M, Si L, Qin W, Li C, Zhang J, Yang H, et al. Predictive value of serum albumin level for the prognosis of severe sepsis without exogenous human albumin administration. J Intensive Care Med. 2018;33:687-94.
Pollak AJ, Strong RM, Gribbon R, Shah H. Lack of predictive value of the APACHE II score in hypoalbuminemic patients. JPEN J Parenter Enteral Nutr. 1991;15:313-5.