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Clinical Trial
. 2021 Dec 17;11(1):24158.
doi: 10.1038/s41598-021-03449-8.

Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality

Klementina Ocskay  1   2 , Zsófia Vinkó  1 , Dávid Németh  1 , László Szabó  1   3 , Judit Bajor  4 , Szilárd Gódi  4 , Patrícia Sarlós  4 , László Czakó  5 , Ferenc Izbéki  6 , József Hamvas  7 , Mária Papp  8 , Márta Varga  9 , Imola Török  10 , Artautas Mickevicius  11   12 , Ville Sallinen  13 , Elena Ramirez Maldonado  14 , Shamil Galeev  15 , Alexandra Mikó  1 , Bálint Erőss  1   2   16 , Marcell Imrei  1   2 , Péter Jenő Hegyi  1   2   16 , Nándor Faluhelyi  17 , Orsolya Farkas  17 , Péter Kanizsai  18 , Attila Miseta  19 , Tamás Nagy  19 , Roland Hágendorn  20 , Zsolt Márton  20 , Zsolt Szakács  1   20 , Andrea Szentesi  1   2   3 , Péter Hegyi  1   2   16 , Andrea Párniczky  21   22   23
Affiliations
Clinical Trial

Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality

Klementina Ocskay et al. Sci Rep. .

Abstract

The incidence and medical costs of acute pancreatitis (AP) are on the rise, and severe cases still have a 30% mortality rate. We aimed to evaluate hypoalbuminemia as a risk factor and the prognostic value of human serum albumin in AP. Data from 2461 patients were extracted from the international, prospective, multicentre AP registry operated by the Hungarian Pancreatic Study Group. Data from patients with albumin measurement in the first 48 h (n = 1149) and anytime during hospitalization (n = 1272) were analysed. Multivariate binary logistic regression and Receiver Operator Characteristic curve analysis were used. The prevalence of hypoalbuminemia (< 35 g/L) was 19% on admission and 35.7% during hospitalization. Hypoalbuminemia dose-dependently increased the risk of severity, mortality, local complications and organ failure and is associated with longer hospital stay. The predictive value of hypoalbuminemia on admission was poor for severity and mortality. Severe hypoalbuminemia (< 25 g/L) represented an independent risk factor for severity (OR 48.761; CI 25.276-98.908) and mortality (OR 16.83; CI 8.32-35.13). Albumin loss during AP was strongly associated with severity (p < 0.001) and mortality (p = 0.002). Hypoalbuminemia represents an independent risk factor for severity and mortality in AP, and it shows a dose-dependent relationship with local complications, organ failure and length of stay.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Relation between albumin level and local complications, as defined by the Revised Atlanta Criteria in acute pancreatitis. All types of local complications were significantly more frequent in the low albumin group. A dose-dependent increase was seen in the rate of local complications and peripancreatic fluid collection in both cohorts and in pancreatic necrosis and pseudocyst in the lowest measured albumin cohort. P < 0.05 is considered significant. Patients with albumin levels < 35 g/L were included in the low albumin group (Groups 5–7).
Figure 2
Figure 2
Relation between albumin level and organ failure, as defined by the Revised Atlanta Criteria in acute pancreatitis. Significantly more patients developed organ failure in the low albumin group in both cohorts. A dose-dependent increase was seen in the case of all analyses in the lowest measured albumin cohort. Heart failure was dose-dependently increased in the on-admission cohort as well. P < 0.005 is considered significant.
Figure 3
Figure 3
Relation between albumin level and disease severity, mortality, length of stay and maximum C-reactive protein level in acute pancreatitis. Severity, mortality, length of stay and maximum C-reactive protein levels were significantly and dose-dependently associated with hypoalbuminemia in both cohorts. P < 0.05 is considered significant.
Figure 4
Figure 4
Receiver operating curves for mortality and severity. AUC area under the curve; best cut-offs are shown in red.
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References

    1. Sarr MG. 2012 revision of the Atlanta classification of acute pancreatitis. Pol. Arch. Med. Wewn. 2013;123:118–124. doi: 10.20452/pamw.1627. - DOI - PubMed
    1. Oettl K, Stauber RE. Physiological and pathological changes in the redox state of human serum albumin critically influence its binding properties. Br. J. Pharmacol. 2007;151:580–590. doi: 10.1038/sj.bjp.0707251. - DOI - PMC - PubMed
    1. Stamler JS, et al. Nitric oxide circulates in mammalian plasma primarily as an S-nitroso adduct of serum albumin. Proc. Natl. Acad. Sci. U.S.A. 1992;89:7674–7677. doi: 10.1073/pnas.89.16.7674. - DOI - PMC - PubMed
    1. Ulldemolins M, Roberts JA, Rello J, Paterson DL, Lipman J. The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients. Clin. Pharmacokinet. 2011;50:99–110. doi: 10.2165/11539220-000000000-00000. - DOI - PubMed
    1. Zhang W, et al. Evaluation of early prognostic factors of mortality in patients with acute pancreatitis: A retrospective study. Gastroenterol. Res. Pract. 2017;2017:8363561. doi: 10.1155/2017/8363561. - DOI - PMC - PubMed

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