Dataset Information

Relationship between human serum albumin and in-hospital mortality in critical care patients with chronic obstructive pulmonary disease.

ABSTRACT:

Background

The relationship between human serum albumin levels and the prognosis of critical care patients with chronic obstructive pulmonary disease (COPD) remains controversial.

Objective

To investigate the relationship between serum albumin levels and in-hospital mortality in critical care patients with COPD. METHODS: This study used a retrospective observational cohort from the Medical Information in Intensive Care database (MIMIC-IV) in the United States. Multivariate Cox regression analysis was used to assess the relationship between serum albumin levels and in-hospital mortality. A restricted cubic spline line was also used to explore nonlinear relationship.

Results

A total of 3,398 critical care patients with COPD were included. The overall in-hospital mortality was 12.4%. We found a negative relationship between human serum albumin and in-hospital mortality (HR = 0.97, 95% CI 0.96-0.99, p = 0.002).

Conclusion

In critical care patients with COPD, there was a negative association between human serum albumin and in-hospital mortality.

SUBMITTER: Ling M

PROVIDER: S-EPMC10174316 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Relationship between human serum albumin and in-hospital mortality in critical care patients with chronic obstructive pulmonary disease.

Ling Ma M Huiyin Li L Shanglin Chen C Haiming Li L Zhanyi Di D Shuchun Wang W Meng Bai B Murong Lu L

Frontiers in medicine 20230427

<h4>Background</h4>The relationship between human serum albumin levels and the prognosis of critical care patients with chronic obstructive pulmonary disease (COPD) remains controversial.<h4>Objective</h4>To investigate the relationship between serum albumin levels and in-hospital mortality in critical care patients with COPD. METHODS: This study used a retrospective observational cohort from the Medical Information in Intensive Care database (MIMIC-IV) in the United States. Multivariate Cox reg ...[more]

PMID: 37181348

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Project description:BackgroundThe relationship between albumin-corrected anion gap (ACAG) and in-hospital mortality in critically ill patients with COPD remains unclear.ObjectiveThis study investigated the association between ACAG levels and the risk of in-hospital mortality in critically ill patients with COPD.DesignA retrospective cohort study.MethodsThis study uses data from the Medical Information Mart for Intensive Care (MIMIC-IV) database. The receiver operating characteristic (ROC) curve was used to determine the optimal threshold for ACAG, and participants were divided into two categories based on this threshold. The primary outcome was in-hospital mortality. We employed univariable and multivariable logistic regression analyses and Kaplan-Meier (KM) survival curves to assess the relationship between ACAG and the risk of in-hospital mortality. Moreover, subgroup analyses were conducted.ResultsA total of 2121 patients (54.7% male) were enrolled in the study. The in-hospital mortality rate was 18.9%. In patients with elevated ACAG levels, the in-hospital mortality rate was significantly higher than in those with lower ACAG levels (27.7% vs 11.3%, p < 0.001). Multivariate logistic regression analysis indicated that even after mitigating for potential confounders, patients in the high ACAG group had significantly greater odds of in-hospital mortality across all models (Model I: OR = 3.000, 95% CI: 2.383-3.777, p < 0.001; Model II: OR = 3.021, 95% CI: 2.397-3.808, p < 0.001; Model III: OR = 1.916, 95% CI: 1.458-2.519, p < 0.001). Patients with elevated ACAG levels have more than twice the risk of in-hospital mortality compared to those with lower levels (hazard ratio (HR): 2.1277, 95% CI: 1.7490-2.5884).ConclusionThis study demonstrates that elevated ACAG levels are strongly associated with an increased risk of in-hospital mortality in critically ill COPD patients, suggesting that ACAG could serve as a potential predictor of adverse outcomes in this patient population.

Project description:BackgroundHigh-sensitivity cardiac troponin T (hs-cTnT) in serum is a useful marker of acute myocardial injury, yet information is limited in patients with chronic obstructive pulmonary disease. We aimed to explore the association between hs-cTnT levels and cardiac and pulmonary dysfunction in patients with stable chronic obstructive pulmonary disease and at-risk individuals.MethodsWe examined community-dwelling adults with/without chronic obstructive pulmonary disease, with a life-long smoking history, current symptoms of dyspnea during exertion, prolonged coughing, and/or sputum. Serum hs-cTnT concentrations were measured, and subjects underwent pulmonary function tests, high-resolution computed tomography of the chest, an echocardiogram, and a 6-minute walking test.ResultsEighty-six stable patients were identified (mean age 65.5 years; predicted forced expiratory volume in 1 second [FEV1% predicted] 75.0%). Their overall mean hs-cTnT level was 0.008 ng/mL. Logarithmically transformed hs-cTnT levels significantly and positively correlated with age, smoking index, serum high-sensitivity C-reactive protein levels, right ventricle systolic pressure, low attenuation area percentage, and brain natriuretic peptide levels (range r=0.231-0.534, P=0.000 to P=0.042). Further, logarithmically transformed hs-cTnT values significantly and negatively correlated with forced vital capacity, FEV1% predicted, diffusion capacity, arterial oxygen tension, and 6-minute walking distance (range r= -0.482 to -0.377, P=0.000 to P=0.002). Multivariate analyses showed that hs-cTnT values varied independently according to the following three parameters: high-sensitivity C-reactive protein levels (B=0.157, β=0.450, t=3.571, P=0.001), age (B=0.008, β=0.352, t=2.789, P=0.009), and right ventricular systolic pressure (B=0.008, β=0.280, t=2.202, P=0.035).ConclusionEven in patients with stable chronic obstructive pulmonary disease, the serum troponin T concentration was controlled by at least three major factors, ie, systemic inflammation, advancing age, and right cardiac overload.

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Project description:BackgroundNo personalized prediction model or standardized algorithm exists to identify those at high risk of death among severe community-acquired pneumonia (SCAP) patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the risk factors and to develop a useful nomogram for prediction of mortality in those patients.MethodsWe performed a retrospective, observational, cohort study in the intensive care unit (ICU) of West China Hospital, Sichuan University with all consecutive SCAP patients with COPD between December 2011 and December 2018. The clinical data within 24 h of admission to ICU were collected. The primary outcome was hospital mortality. We divided the patients into training and testing cohorts (70% versus 30%) randomly. In the training cohort, univariate and multivariate logistic regression analysis were used to identify independent risk factors applied to develop a nomogram. The prediction model was assessed in both training and testing cohorts.ResultsFinally, 873 SCAP patients with COPD were included, among which the hospital mortality was 41.4%. In training cohort, the independent risk factors for hospital mortality were increased age, diabetes, chronic renal diseases, decreased systolic blood pressure (SBP), and elevated fibrinogen, interleukin 6 (IL-6) and blood urea nitrogen (BUN). The C index was 0.840 (95% CI 0.809-0.872) in training cohort and 0.830 (95% CI 0.781-0.878) in testing cohort. Furthermore, the time-dependent AUC, calibration plots, DCA and clinical impact curves indicated the model had good predictive performance. Significant association of risk stratification based on nomogram with mortality was also found (P for trend < 0.001). The restricted cubic splines suggested that estimated associations between these predictors and hospital mortality were all linear relationships.ConclusionWe developed a prediction model including seven risk factors for hospital mortality in patients with SCAP and COPD. It can be used for early risk stratification in clinical practice after more external validation.

Dataset Information

Relationship between human serum albumin and in-hospital mortality in critical care patients with chronic obstructive pulmonary disease.

Background

Objective

Results

Conclusion

Publications

Relationship between human serum albumin and in-hospital mortality in critical care patients with chronic obstructive pulmonary disease.

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