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Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?

This study investigates the prognostic impact of albumin levels in patients with cardiogenic shock (CS). Intensive care unit (ICU) related mortality in CS patients remains unacceptably high despite improvement concerning the treatment of CS patients. Limited data regarding the prognostic value of al...

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Autores principales: Schupp, Tobias, Behnes, Michael, Rusnak, Jonas, Ruka, Marinela, Dudda, Jonas, Forner, Jan, Egner-Walter, Sascha, Barre, Max, Abumayyaleh, Mohammad, Bertsch, Thomas, Müller, Julian, Akin, Ibrahim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10138505/
https://www.ncbi.nlm.nih.gov/pubmed/37108536
http://dx.doi.org/10.3390/ijms24087375
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author Schupp, Tobias
Behnes, Michael
Rusnak, Jonas
Ruka, Marinela
Dudda, Jonas
Forner, Jan
Egner-Walter, Sascha
Barre, Max
Abumayyaleh, Mohammad
Bertsch, Thomas
Müller, Julian
Akin, Ibrahim
author_facet Schupp, Tobias
Behnes, Michael
Rusnak, Jonas
Ruka, Marinela
Dudda, Jonas
Forner, Jan
Egner-Walter, Sascha
Barre, Max
Abumayyaleh, Mohammad
Bertsch, Thomas
Müller, Julian
Akin, Ibrahim
author_sort Schupp, Tobias
collection PubMed
description This study investigates the prognostic impact of albumin levels in patients with cardiogenic shock (CS). Intensive care unit (ICU) related mortality in CS patients remains unacceptably high despite improvement concerning the treatment of CS patients. Limited data regarding the prognostic value of albumin in patients with CS is available. All consecutive patients with CS from 2019 to 2021 were included at one institution. Laboratory values were retrieved from the day of disease onset (day 1) and days 2, 3, 4, and 8 thereafter. The prognostic impact of albumin was tested for 30-day all-cause mortality. Moreover, the prognostic performance of albumin decline during ICU treatment was examined. Statistical analyses included univariable t-test, Spearman’s correlation, Kaplan–Meier analyses, multivariable mixed analysis of variance (ANOVA), C-Statistics, and Cox proportional regression analyses. In total, 230 CS patients were included, with an overall all-cause mortality at 30 days of 54%. The median albumin on day 1 was 30.0 g/L. Albumin on day 1 was able to discriminate between 30-day survivors and non-survivors (area under the curve (AUC) 0.607; 0.535–0.680; p = 0.005). CS patients with albumin < 30.0 g/L were associated with an increased risk of 30-day all-cause mortality (63% vs. 46%; log-rank p = 0.016; HR = 1.517; 95% CI 1.063–2.164; p = 0.021), which was demonstrated even after multivariable adjustment. Moreover, a decrease of albumin levels by ≥20% from day 1 to day 3 was accompanied by a higher risk of 30-days all-cause mortality (56% vs. 39%; log-rank p = 0.036; HR = 1.645; 95% CI 1.014–2.669; p = 0.044). Especially when combined with lactate, creatinine, and cardiac troponin I, reliable discrimination of 30-day all-cause mortality was observed, including albumin in CS risk stratification models (AUC = 0.745; 95% CI 0.677–0.814; p = 0.001). In conclusion, low baseline albumin levels as well as a decay of albumin levels during the course of ICU treatment, deteriorate prognostic outcomes in CS patients. The additional assessment of albumin levels may further improve risk stratification in CS patients.
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spelling pubmed-101385052023-04-28 Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock? Schupp, Tobias Behnes, Michael Rusnak, Jonas Ruka, Marinela Dudda, Jonas Forner, Jan Egner-Walter, Sascha Barre, Max Abumayyaleh, Mohammad Bertsch, Thomas Müller, Julian Akin, Ibrahim Int J Mol Sci Article This study investigates the prognostic impact of albumin levels in patients with cardiogenic shock (CS). Intensive care unit (ICU) related mortality in CS patients remains unacceptably high despite improvement concerning the treatment of CS patients. Limited data regarding the prognostic value of albumin in patients with CS is available. All consecutive patients with CS from 2019 to 2021 were included at one institution. Laboratory values were retrieved from the day of disease onset (day 1) and days 2, 3, 4, and 8 thereafter. The prognostic impact of albumin was tested for 30-day all-cause mortality. Moreover, the prognostic performance of albumin decline during ICU treatment was examined. Statistical analyses included univariable t-test, Spearman’s correlation, Kaplan–Meier analyses, multivariable mixed analysis of variance (ANOVA), C-Statistics, and Cox proportional regression analyses. In total, 230 CS patients were included, with an overall all-cause mortality at 30 days of 54%. The median albumin on day 1 was 30.0 g/L. Albumin on day 1 was able to discriminate between 30-day survivors and non-survivors (area under the curve (AUC) 0.607; 0.535–0.680; p = 0.005). CS patients with albumin < 30.0 g/L were associated with an increased risk of 30-day all-cause mortality (63% vs. 46%; log-rank p = 0.016; HR = 1.517; 95% CI 1.063–2.164; p = 0.021), which was demonstrated even after multivariable adjustment. Moreover, a decrease of albumin levels by ≥20% from day 1 to day 3 was accompanied by a higher risk of 30-days all-cause mortality (56% vs. 39%; log-rank p = 0.036; HR = 1.645; 95% CI 1.014–2.669; p = 0.044). Especially when combined with lactate, creatinine, and cardiac troponin I, reliable discrimination of 30-day all-cause mortality was observed, including albumin in CS risk stratification models (AUC = 0.745; 95% CI 0.677–0.814; p = 0.001). In conclusion, low baseline albumin levels as well as a decay of albumin levels during the course of ICU treatment, deteriorate prognostic outcomes in CS patients. The additional assessment of albumin levels may further improve risk stratification in CS patients. MDPI 2023-04-17 /pmc/articles/PMC10138505/ /pubmed/37108536 http://dx.doi.org/10.3390/ijms24087375 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schupp, Tobias
Behnes, Michael
Rusnak, Jonas
Ruka, Marinela
Dudda, Jonas
Forner, Jan
Egner-Walter, Sascha
Barre, Max
Abumayyaleh, Mohammad
Bertsch, Thomas
Müller, Julian
Akin, Ibrahim
Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?
title Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?
title_full Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?
title_fullStr Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?
title_full_unstemmed Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?
title_short Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock?
title_sort does albumin predict the risk of mortality in patients with cardiogenic shock?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10138505/
https://www.ncbi.nlm.nih.gov/pubmed/37108536
http://dx.doi.org/10.3390/ijms24087375
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