Serum Albumin as a Biomarker of Poor Prognosis in the Pediatric Patients in Intensive Care Unit
- Author:
Young Suh KIM
1
;
In Suk SOL
;
Min Jung KIM
;
Soo Yeon KIM
;
Jong Deok KIM
;
Yoon Hee KIM
;
Kyung Won KIM
;
Myung Hyun SOHN
;
Kyu Earn KIM
Author Information
- Publication Type:Original Article
- Keywords: albumins; intensive care units; mortality; pediatrics
- MeSH: Adult; Albumins; Blood Platelets; C-Reactive Protein; Child; Critical Care; Humans; Hypoalbuminemia; Incidence; Intensive Care Units; Lactic Acid; Medical Records; Mortality; Neutrophils; Pediatrics; Prognosis; Renal Insufficiency; Retrospective Studies; Serum Albumin; Shock, Septic
- From:The Korean Journal of Critical Care Medicine 2017;32(4):347-355
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Serum albumin as an indicator of the disease severity and mortality is suggested in adult patients, but its role in pediatric patients has not been established. The objectives of this study are to investigate the albumin level as a biomarker of poor prognosis and to compare it with other mortality predictive indices in children in intensive care unit (ICU). METHODS: Medical records of 431 children admitted to the ICU at Severance Hospital from January 1, 2012 to December 31, 2015 were retrospectively analyzed. Children who expired within 24 hours after ICU admission, children with hepatic or renal failure, and those who received albumin replacement before ICU admission were excluded. RESULTS: The children with hypoalbuminemia had higher 28-day mortality rate (24.60% vs. 9.28%, P < 0.001), Pediatric Index of Mortality (PIM) 3 score (9.23 vs. 8.36, P < 0.001), Pediatric Risk of Mortality (PRISM) III score (7.0 vs. 5.0, P < 0.001), incidence of septic shock (12% vs. 3%, P < 0.001), C-reactive protein (33.0 mg/L vs. 5.8 mg/L, P < 0.001), delta neutrophil index (2.0% vs. 0.6%, P < 0.001), lactate level (1.6 mmol/L vs. 1.2 mmol/L, P < 0.001) and lower platelet level (206,000/µl vs. 341,000/µl, P < 0.001) compared to the children with normal albumin level. PIM 3 (r = 0.219, P < 0.001) and PRISM III (r = 0.375, P < 0.001) were negatively correlated with serum albumin level, respectively. CONCLUSIONS: Our results highlight that hypoalbuminemia can be a biomarker of poor prognosis including mortality in the children in ICU.
