Prognostic value of serum albumin for patients with acute aortic dissection: A retrospective cohort study

Serum albumin (SA) is associated with inflammation and thrombosis, which are involved in acute aortic dissection (AAD). Our aim was to investigate the effect of SA level on survival in patients with AAD. We analyzed 777 patients with AAD. The patients were divided into hypoalbuminemia and non-hypoalbuminemia groups according to their AAD Stanford classification. Multivariable Cox regression was used to investigate the association between SA levels and in-hospital mortality in type A and B AAD. A total of 103 (13.3%) patients died in-hospital. The in-hospital mortality in type A and B patients with hypoalbuminemia was higher compared to those without (type A: 34.2% vs 13.9%, P <.001; type B: 7.9% vs 1.6%, P = .001). Kaplan–Meier analysis showed that survival was significantly lower in patients with hypoalbuminemia compared to those without, regardless of AAD type (type A: log-rank χ(2) = 14.71; P <.001; Type B: log-rank χ(2) = 10.42; P = .001). After adjusting for confounding factors, hypoalbuminemia was an independent predictor of in-hospital mortality in patients with either type A (HR, 2.492; 95% confidence interval [CI], 1.247–4.979; P = .010) or type B (HR, 8.729; 95% CI, 1.825–41.736; P = .007). SA is independently associated with increased in-hospital mortality in both type A and B AAD.