Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 7;14(13):4790.
doi: 10.3390/jcm14134790.

The Efficacy of Albumin Infusion in Septic Patients with Hypoalbuminemia: An International Retrospective Observational Study

Hsin-Yu Liu  1 , Yu-Ching Chen  2 , Ju-Fang Liu  3 , Pei-Sung Hsu  4 , Wen-Pin Cheng  5   6 , Shih-Sen Lin  4   7   8
Affiliations

The Efficacy of Albumin Infusion in Septic Patients with Hypoalbuminemia: An International Retrospective Observational Study

Hsin-Yu Liu et al. J Clin Med. .

Abstract

Background/Objectives: Albumin supplementation is widely used for hypoalbuminemia treatment in patients with critical illness, especially those with cirrhosis. However, studies have demonstrated that routine albumin administration is not always advantageous. We examined how albumin supplementation affects survival outcomes in patients with sepsis with hypoalbuminemia. Methods: This study was conducted by researchers in Taiwan using data from the TriNetX research platform, covering the period from 1 April 2014 to 30 April 2024. This platform aggregates real-world data from healthcare organizations worldwide. From this dataset, 1,147,433 patients who developed sepsis and hypoalbuminemia with albumin levels <3.5 g/dL were identified. The study population was stratified into two groups on the basis of whether they received albumin infusion or not. To compare outcomes, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated between propensity-score-matched patients who did and did not receive albumin supplementation. Subgroup analysis by albumin levels was conducted. Results: Albumin infusion was linked to increased risks of 30-day mortality (HR [95% CI] = 1.800 [1.774-1.827], p < 0.05), shock (HR [95% CI] = 1.436 [1.409-1.465], p < 0.05), septic shock (HR [95% CI] = 1.384 [1.355-1.415], p < 0.05), hypovolemic shock (HR [95% CI] = 1.496 [1.391-1.608], p < 0.05), cardiogenic shock (HR [95% CI] = 1.553 [1.473-1.637], p < 0.05), heart failure (HR [95% CI] = 1.098 [1.080-1.116], p < 0.05), and pulmonary edema (HR [95% CI] = 1.479 [1.438-1.520], p < 0.05). The subgroup analysis by albumin levels revealed a trend of increased mortality risk with albumin supplementation in patients with high baseline albumin levels. Conclusions: Patients with sepsis with hypoalbuminemia who received albumin supplementation exhibited high 30-day mortality rates and increased risks of shock, heart failure, and pulmonary edema compared with those who did not. These findings indicate that routine albumin administration may be linked with unfavorable outcomes in these patients.

Keywords: albumin supplementation; hypoalbuminemia; sepsis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of the cohort construction.
Figure 2
Figure 2
The Kaplan–Meier curve of the survival probability of mortality.
Figure 3
Figure 3
A comparison of primary outcomes between the albumin intervention group and the control group.
Figure 4
Figure 4
Mortality in subgroup analysis based on albumin levels.
Figure 5
Figure 5
Shock in subgroup analysis based on albumin levels.
Figure 6
Figure 6
Heart failure in subgroup analysis based on albumin levels.
Figure 7
Figure 7
Pulmonary edema in subgroup analysis based on albumin levels.
See this image and copyright information in PMC

References

    1. Brock F., Bettinelli L.A., Dobner T., Stobbe J.C., Pomatti G., Telles C.T. Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders. Rev. Lat. Am. Enferm. 2016;24:e2736. doi: 10.1590/1518-8345.0260.2736. - DOI - PMC - PubMed
    1. Moramarco S., Morciano L., Morucci L., Messinese M., Gualtieri P., Carestia M., Ciccacci F., Orlando S., Buonomo E., Legramante J.M., et al. Epidemiology of Hypoalbuminemia in Hospitalized Patients: A Clinical Matter or an Emerging Public Health Problem? Nutrients. 2020;12:3656. doi: 10.3390/nu12123656. - DOI - PMC - PubMed
    1. Gounden V., Vashisht R., Jialal I. StatPearls. StatPearls Publishing; Treasure Island, FL, USA: 2023. Hypoalbuminemia. - PubMed
    1. Melia D., Post B. Human albumin solutions in intensive care: A review. J. Intensive Care Soc. 2021;22:248–254. doi: 10.1177/1751143720961245. - DOI - PMC - PubMed
    1. Bai Z., Mendez-Sanchez N., Romeiro F.G., Mancuso A., Philips C.A., Tacke F., Basaranoglu M., Primignani M., Ibrahim M., Wong Y.J., et al. Use of albumin infusion for cirrhosis-related complications: An international position statement. JHEP Rep. 2023;5:100785. doi: 10.1016/j.jhepr.2023.100785. - DOI - PMC - PubMed

LinkOut - more resources