Lower serum albumin level is associated with increased risk of hospital admission and length of stay in hospital among incident hemodialysis patients by using overdispersed model

2020 ◽  
Author(s):  
Koray Uludag ◽  
Gulsah Boz ◽  
Ali Ihsan Gunal
Keyword(s):  
Length Of Stay ◽  
Serum Albumin ◽  
Hospital Admission ◽  
Serum Albumin Level ◽  
Hemodialysis Patients ◽  
Albumin Level ◽  
Lower Serum ◽  
Increased Risk

Lower Serum Albumin Level Is Associated With an Increased Risk for Loss of Residual Kidney Function in Patients Receiving Peritoneal Dialysis

2019 ◽  
Vol 24 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Shunsuke Yamada ◽  
Yasuhiro Kawai ◽  
Shoji Tsuneyoshi ◽  
Hiroaki Tsujikawa ◽  
Hokuto Arase ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Kidney Function ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Lower Serum ◽  
Residual Kidney Function ◽  
Increased Risk

scholarly journals Hubungan antara Kadar Serum Albumin Awal dengan Lama Rawat Inap dan Status Pulang Pasien Dewasa di Rumah Sakit

2004 ◽  
Vol 1 (1) ◽  
pp. 19
Author(s):  
Weni Kurdanti ◽  
Hamam Hadi ◽  
Susetyowati Susetyowati
Keyword(s):  
Length Of Stay ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Normal Serum ◽  
Hospital Death ◽  
Increased Risk ◽  
Neurological Patients ◽  
Recovery Status ◽  
Low Serum

Background: Several community studies have reported a relationship between a low serum albumin level and increased risk of hospital death, nosocomial infection, and length of stay. But this kind of study is still lacking in Indonesia.Objective: To assess the relationship between admission serum albumin levels with length of stay and recovery rate among adult hospitalized patients.Methods: This cohort study was done in 2002. Subjects of this study were adults, inpatient of internal and neurological departments of Dr.Sardjito, Dr. M. Jamil and Sanglah hospitals. Serum albumin level, total lymphocyte count (TLC), and hemoglobin from each subject were collected at the admission. Energy intake of each subject was obtained using visual Comstock method. Information of length of stay and recovery status at discharge was obtained from medical records.Results: On average the length of stay (LOS) in patients with normal serum albumin was 9.8 days. In patients with low serum albumin the LOS was 2 days longer (p<0.05) than that in patient with normal serum albumin. LOS was not significantly different by serum albuminlevels among neurological and cancer patients. Neurological patients with low serum albumin had 10 times greater risk for not recover on discharge than non neurological patients with normal serum albumin.Conclusion: Serum albumin level at admission was associated with LOS and recovery status on discharge.

Hypoalbuminemia Is An Independent Prognostic Factor In Myelodysplastic Syndromes

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4001-4001
Author(s):  
Maria Corrales-Yepez ◽  
Mohamed A. Kharfan-Dabaja ◽  
Jeffrey Lancet ◽  
Alan F. List ◽  
Eric Padron ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Risk Group ◽  
Risk Groups ◽  
Albumin Level ◽  
Refractory Anemia ◽  
Lower Serum ◽  
Kaplan Meier ◽  
Low Serum

Abstract Abstract 4001 Background: Low serum albumin level is known to be an adverse prognostic factor in patients with malignancies such as multiple myeloma. We previously reported that severe hypoalbuminemia (&lt;3.0 g/dl) at day +90 post allogeneic hematopoietic stem cell transplant (AHCT) was an independent predictor of non-relapse and overall mortality in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) (Kharfan-Dabaja et al Biol Blood Marrow Transplant. 2010 Jul). In this study we examined prognostic value of serum albumin level in patients with MDS. Methods: Data were analyzed from the Moffitt Cancer Center (MCC) MDS database with chart review verification. The primary objective was to examine the role of serum albumin at time of presentation to MCC as a prognostic marker for overall survival (OS). Patients were divided into 3 groups of serum albumin levels (≤ 3.5, 3.6–4.0 and &gt; 4.0 g/dl). The Kaplan–Meier method was used to estimate median OS. The log rank test was used to compare Kaplan–Meier survival estimates between two groups. Cox proportional hazards regression was used for multivariable analysis. Results: Between January 2001 and December 2009, 844 patients were captured by the MCC MDS database. The median age was 69 years. MDS subtypes were coded as refractory anemia (RA) (n=98;12%), refractory anemia with ring sideroblasts (RARS) (n=76;9%), del(5q) (n=20;2.4%), refractory cytopenia with multi-lineage dysplasia (RCMD) (n=96;11%), refractory anemia with excess blasts (RAEB) (n=255;30%), therapy related MDS (n=22;2.6%), and MDS-NOS (n=275; 33%). The distribution of IPSS risk groups was: 18.7% Low risk, 42.9% Intermediate-1 (Int-1), 19.9% Int-2, 5.3% High risk, and 13.2% unknown. Baseline characteristics for the three patient groups defined by serum albumin level are summarized in (Table-1). There was no difference in red blood cell transfusion dependency (RBC-TD) rate between the 3 groups (p=0.21). The median OS for all patients was 36 months (95% confidence interval (CI) 31.5–40.5 mo). Age, IPSS risk group, RBC-TD, Serum ferritin were statistically significant prognostic factors in univariable analysis. The median OS was 19 mo (95%CI= 14.9–23.1 mo), 35 mo (95%CI= 28.7–41.3 mo), and 53 mo (95%CI= 44.7–61.3 mo) for patients with serum albumin levels ≤ 3.5 g/dl, 3.6–4.0 g/dl, &gt; 4.0 g/dl, respectively. (Figure-1) (p= &lt;0.005). After adjustment for age, RBC-TD, OS was statistically significantly inferior among MDS patients with lower serum albumin (Hazard Ratio (HR) = 0.79.; 95%CI= 0.69–0.90; p= 0.001), and higher-risk IPSS group (HR=1.67; 95%CI=1.48-1.87; p= &lt;0.005). The overall rate of AML transformation was 29.2%. Rate of AML transformation was higher in patients with lower serum albumin, 38% in patients with serum albumin ≤ 3.5 g/dl, 30% for patients 3.6–4.0 g/dl, and 23% in patients with serum albumin &gt; 4.0 g/dl (p-value 0.005). Among patients in the Low/Int-1 IPSS risk group, the median OS was 28 mo (95%CI=15.7-40.3 mo), 48 mo (95%CI=38.8-58.0 mo), and 60 mo (95%CI=47.6-72.4 mo) for patients with serum albumin levels ≤ 3.5 g/dl, 3.6–4.0 g/dl and &gt; 4.0 g/dl, respectively (p=0.003). Among patients in the Int-2/High IPSS risk group, the median OS was 16 mo (95%CI 13.3–15.7 mo), 22 mo (95%CI 18.0–26.0 mo), and 21 mo (95%CI 8.8–33.2 mo) respectively for patients with serum albumin levels ≤ 3.5 g/dl, 3.6–4.0 g/dl and &gt; 4.0 g/dl, respectively p=0.03). Conclusion: In this retrospective analysis of a large single institution MDS database, serum albumin is found to be an independent prognostic factor for OS and AML transformation in MDS patients. The prognostic power of low serum albumin was greatest among patients with Low/Int-1 IPSS risk group, but remained an independent variable across all risk groups. Serum albumin may also be a surrogate marker of general health, co- morbidities, and performance status. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Aortic Arch Calcification as a Predictor of Repeated Arteriovenous Fistula Failure within 1-Year in Hemodialysis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Yit-Sheung Yap ◽  
Kai-Ting Ting ◽  
Wen-Che Chi ◽  
Cheng-Hao Lin ◽  
Yi-Chun Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Arteriovenous Fistula ◽  
Aortic Arch ◽  
Serum Albumin Level ◽  
Binary Logistic Regression ◽  
Hemodialysis Patients ◽  
Albumin Level ◽  
Binary Logistic Regression Analysis ◽  
The Impact ◽  
Aortic Arch Calcification

Objectives. The aim of the study was to identify the factors associated with repeated arteriovenous fistula (AVF) failure within 1-year, especially the impact of aortic arch calcification (AAC) on patency of AVF.Materials and Methods. We retrospectively assessed chest radiography in hemodialysis patients who had undergone initial AVF. The extent of AAC was categorized into four grades (0–3). The association between AAC grade, other clinical variables, and repeated failure of AVF was then analyzed by binary logistic regression analysis.Results. This study included 284 patients (158 males, mean age61.7±13.1years). Patients with higher AAC grade were older, had more frequently diabetes mellitus and cardiovascular disease, had lower diastolic blood pressure, and had higher corrected calcium and lower intact parathyroid hormone levels. In multivariate analysis, the presence of higher AAC grade (odds ratio (95% confidence interval): 2.98 (1.43–6.23);p=0.004), lower mean corrected calcium (p=0.017), and mean serum albumin level (p=0.008) were associated with repeated failure of AVF.Conclusions. The presence of higher AAC grade, lower mean corrected calcium and mean serum albumin level were independently associated with repeated AVF failure within 1 year in hemodialysis patients.

scholarly journals Analysis of risk factors and outcome in peritoneal dialysis patients with early-onset peritonitis: a multicentre, retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e029949 ◽  
Author(s):  
Xiaoyan Ma ◽  
Yingfeng Shi ◽  
Min Tao ◽  
Xiaolu Jiang ◽  
Yi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Retrospective Cohort ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
First Episode ◽  
Lower Serum ◽  
Factors Associated ◽  
All Cause Mortality ◽  
Technique Failure

ObjectivesTo investigate the risk factors associated with early-onset peritonitis (EOP) and their influence on patients’ technique survival and mortality.Study designRetrospective, cohort study.SettingThree peritoneal dialysis (PD) units in Shanghai.ParticipantsPD patients from 1 June 2006 to 1 May 2018 were recruited and followed up until 31 December 2018. According to time-to-first episode of peritonitis, patients were divided into non-peritonitis (n=144), EOP (≤6 months, n=74) and late-onset peritonitis (LOP) (>6 months, n=139).Primary and secondary outcome measuresEOP was defined as the first episode of peritonitis occurring within 6 months after the initiation of PD. The outcomes were all-cause mortality and technique failure.ResultsOf the 357 patients, 74 (20.7%) patients developed their first episode of peritonitis within the first 6 months. Compared with the LOP group, the EOP group had older ages, more female patients, higher Charlson Comorbidity Index (CCI) score, lower serum albumin levels and renal function at the time of initiation of PD, and higher diabetes mellitus and peritonitis rates (p<0.05).Staphylococcuswas the most common Gram-positive organism in both EOP and LOP groups. The multivariate logistic regression analysis showed that factors associated with EOP included a higher CCI score (OR 1.285, p=0.011), lower serum albumin level (OR 0.924, p=0.016) and lower Kt/V (OR 0.600, p=0.018) at start of PD. In the Cox proportional-hazards model, EOP was more likely a predictor of technique failure (HR 1.801, p=0.051). There was no difference between EOP and LOP for all-cause mortality.ConclusionA higher CCI score and lower serum albumin level and Kt/V at PD initiation were significantly associated with EOP. EOP also predicted a high peritonitis rate and poor clinical outcome.

Predicting nonroutine discharge in patients undergoing surgery for vertebral column tumors

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Jeff Ehresman ◽  
Zach Pennington ◽  
James Feghali ◽  
Andrew Schilling ◽  
Andrew Hersh ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Vertebral Column ◽  
Serum Albumin Level ◽  
Frailty Index ◽  
Emergency Admission ◽  
Albumin Level ◽  
Comprehensive Cancer Center ◽  
Lower Serum ◽  
Web Based ◽  
Inpatient Facility

OBJECTIVEMore than 8000 patients are treated annually for vertebral column tumors, of whom roughly two-thirds will be discharged to an inpatient facility (nonroutine discharge). Nonroutine discharge is associated with increased care costs as well as delays in discharge and poorer patient outcomes. In this study, the authors sought to develop a prediction model of nonroutine discharge in the population of vertebral column tumor patients.METHODSPatients treated for primary or metastatic vertebral column tumors at a single comprehensive cancer center were identified for inclusion. Data were gathered regarding surgical procedure, patient demographics, insurance status, and medical comorbidities. Frailty was assessed using the modified 5-item Frailty Index (mFI-5) and medical complexity was assessed using the modified Charlson Comorbidity Index (mCCI). Multivariable logistic regression was used to identify independent predictors of nonroutine discharge, and multivariable linear regression was used to identify predictors of prolonged length of stay (LOS). The discharge model was internally validated using 1000 bootstrapped samples.RESULTSThe authors identified 350 patients (mean age 57.0 ± 13.6 years, 53.1% male, and 67.1% treated for metastatic vs primary disease). Significant predictors of prolonged LOS included higher mCCI score (β = 0.74; p = 0.026), higher serum absolute neutrophil count (β = 0.35; p = 0.001), lower hematocrit (β = −0.34; p = 0.001), use of a staged operation (β = 4.99; p < 0.001), occurrence of postoperative pulmonary embolism (β = 3.93; p = 0.004), and surgical site infection (β = 9.93; p < 0.001). Significant predictors of nonroutine discharge included emergency admission (OR 3.09; p = 0.001), higher mFI-5 score (OR 1.90; p = 0.001), lower serum albumin level (OR 0.43 per g/dL; p < 0.001), and operations with multiple stages (OR 4.10; p < 0.001). The resulting statistical model was deployed as a web-based calculator (https://jhuspine4.shinyapps.io/Nonroutine_Discharge_Tumor/).CONCLUSIONSThe authors found that nonroutine discharge of patients with surgically treated vertebral column tumors was predicted by emergency admission, increased frailty, lower serum albumin level, and staged surgical procedures. The resulting web-based calculator tool may be useful clinically to aid in discharge planning for spinal oncology patients by preoperatively identifying patients likely to require placement in an inpatient facility postoperatively.

Lower serum albumin level is associated with higher fractional excretion of creatinine

2013 ◽  
Vol 18 (3) ◽  
pp. 469-474 ◽  
Author(s):  
Masaru Horio ◽  
Enyu Imai ◽  
Yoshinari Yasuda ◽  
Tsuyoshi Watanabe ◽  
Seiichi Matsuo
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Fractional Excretion ◽  
Albumin Level ◽  
Lower Serum

scholarly journals Improved serum albumin level by a polyacrilonitrile membrane in diabetic hemodialysis patients.

1997 ◽  
Vol 30 (11) ◽  
pp. 1289-1293
Author(s):  
Yoshihiro Matsumoto ◽  
Joji Ono ◽  
Ken Sakai ◽  
Sonoo Mizuiri ◽  
Akira Hasegawa
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Hemodialysis Patients ◽  
Albumin Level
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