Impacts of admission serum albumin levels on short-term and long-term mortality in hospitalized patients

• Published in: QJM : An International Journal of Medicine 2020-06, Vol.113 (6), p.393-398
• Main Authors: Thongprayoon, C, Cheungpasitporn, W, Chewcharat, A, Mao, M A, Thirunavukkarasu, S, Kashani, K B
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Male; Middle Aged; Minnesota; Patient Admission - statistics & numerical data; Predictive Value of Tests; Regression Analysis; Retrospective Studies; Risk Factors; Serum Albumin - analysis; Tertiary Care Centers
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcz305

Abstract Aim The aim of this study is to assess the association between admission serum albumin and short- and long-term mortality in all hospitalized patients. Design A single-center cohort study. Methods A retrospective cohort of all adult hospitalized patients at a tertiary referral hospital between January 2009 and December 2013 were analysed. Admission serum albumin was stratified into six groups: ≤2.4, 2.5–2.9, 3.0–3.4, 3.5–3.9, 4.0–4.4 and ≥4.5 g/dl. The outcomes of interest were in-hospital mortality, length of hospital stay and 1-year mortality. Serum albumin of 4–4.4 g/dl was selected as a reference group for outcome comparison. Results A total of 14 075 patients were studied. Admission serum albumin of ≥4.5 g/dl had the lowest in-hospital and 1-year mortality with progressively increased in-hospital mortality observed with decreased admission serum albumin. In adjusted analysis, compared with serum albumin of 4.0–4.4 g/dl, serum albumin of ≤2.4, 2.5–2.9, 3.0–3.4 and 3.5–3.9 were significantly associated with increased in-hospital and 1-year mortality. In contrast, serum albumin of ≥4.5 g/dl was significantly associated with lower 1-year mortality but not in-hospital mortality. Admission serum albumin