American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: https://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
Open Access
Journal Browser
Go
American Journal of Clinical Medicine Research. 2018, 6(1), 1-4
DOI: 10.12691/ajcmr-6-1-1
Open AccessArticle

Retrospective Analyses of 200 Patients Over 65 Years Receiving Albumin Treatment in Intensive Care Unit

Banu CEVIK1 and Yucel YUCE1,

1University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Anaesthesiology and Reanimation Department, Kartal, Istanbul, Turkey

Pub. Date: January 22, 2018

Cite this paper:
Banu CEVIK and Yucel YUCE. Retrospective Analyses of 200 Patients Over 65 Years Receiving Albumin Treatment in Intensive Care Unit. American Journal of Clinical Medicine Research. 2018; 6(1):1-4. doi: 10.12691/ajcmr-6-1-1

Abstract

The aim of this study is to evaluate the effectiveness of albumin infusion in critically ill geriatric patients and discuss the prognostic impact on mortality. This study is a retrospective analysis of patients with hypoalbuminemia (≤2.5 g/dl) over 65 years and older followed-up in a 38-bed-mixed medical-surgical tertiary intensive care unit (ICU) of a 650-bed-academic hospital affiliated to University of Health Sciences in İstanbul during 1-year-period. We collected the data including sex, cause of admission, length of stay, duration of mechanical ventilation and APACHE II scores from patients’ medical records. The amount of albumin infused per patient and laboratory evaluation concerning albumin levels was processed by hospital electronic database. Overall 200 patients were included study. Among the patients, 90 (45%) were female, and 110 (53.5%) were male with overall mean age of 78.62±7.63 years. The cause of admission was due to non-surgical reasons in 119(59.5%) patients. Mean length of stay and mechanical ventilation time was significantly higher in non-survivors. The amount of albumin used per patient was similar in both study groups (p=0.276). Pretreatment level of serum album was 2.15±0.28 g/dl and 2.10±0.31 g/dl in both groups respectively (p=0.364) having no significant increase after treatment (p=0.352). In the non-survivors group, APACHE II score was significantly high. Long-term mortality ratio was significantly high which indicated that albumin had no beneficial effect on long-term mortality. The albumin transfusion in critically ill patients over 65 years old has no considerable effect on the treatment of hypoalbuminemia and ICU mortality.

Keywords:
albumin APACHE II mortality

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  United Nations (UN) Department of Economic and Social Affairs, Population Division World Population Ageing 2015. http://www.un.org/en/development/desa/population/publication/pdf/ageing/WPA2015_Report.pdf (access date: 27.12.2017).
 
[2]  Turkish Statistical Institute, Population Projections, 2013-2075. http://www.turkstat.gov.tr/PreHaberBultenleri.do?id=15844 (access date: 27.12.2017).
 
[3]  Lyons O, Whelan B, Bennett K, O’Riordan D, Silke B. Serum albumin as an outcome predictor in hospital emergency medical admissions. Eur J Intern Med 2010; 21(1): 17-20.
 
[4]  Hankins J. The role of albumin in fluid balance. Nursing 2007; 37 (12 Pt.1):14-5.
 
[5]  Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients Cochrane Database Syst Rev. 2013 Feb 28; (2): CD000567.
 
[6]  Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13(10): 818-29.
 
[7]  Vincent JL, Russell JA, Jacob M, Martin G, Guidet B, Wernerman J, Ferrer R, McCluskey SA, Gattinoni L. Albumin administration in the acutely ill: what is new and where next? Crit Care 2014; 16; 18(4): 231.
 
[8]  The SAFE Study Investigators. A Comparison of Albumin and Saline for Fluid Resuscitation in the Intensive Care Unit. N Engl J Med 2004; 350: 2247-56.
 
[9]  Hannan JL, Radwany SM, Albanese T. In-hospital mortality in patients older than 60 years with very low albumin levels. J Pain Symptom Manage. 2012; 43(3): 631-7.
 
[10]  Harith S,Shahar S, Yusoff NAM, Kamaruzzaman SB, Hua PPJ. The magnitude of malnutrition among hospitalized elderly patients in University Malaya Medical Center. Health Environ J 2010; 1(2): 64-72.
 
[11]  Sullivan DH, Sun S, Walls RC. Protein-energy undernutrition among elderly hospitalized patients: a prospective study. JAMA 1999; 281 (21): 2013-9.
 
[12]  PE Wischmeyer. Malnutrition in the acutely ill patient: is it more than just protein and energy? S Afr J Clin Nutr 2011; 24(3): S1-S7.
 
[13]  Bharadwaj S, Ginoya S, Tandon P, Gohel TD, Guirguis J, Vallabh H, Jevenn A, Hanouneh I. Malnutrition: laboratory markers vs nutritional assessment. Gastroenterology Report, 4(4), 2016, 272-280.
 
[14]  Onal O, Ozgun G. Comparison of the course and prognosis of geriatric patients admitted to the intensive care unit according to BMI and albumin values. Anesth Pain Med 2016; 6(1): e32509.
 
[15]  Morley JE. Anorexia of aging: Physiologic and pathologic. Am J Clin Nutr 1997; 66(4): 760-73.
 
[16]  Gurlich R, Maruna P, Kalvach Z, Peskova M, Germak J, Frasko R. Colon resection of elderly patients comparison of data from the Czech Republic. Arch Gerontol Geriatr 2005; 41(2): 183-90.
 
[17]  Hoekstra HJ. Cancer surgery in elderly. Eur J Cancer 2001; 37: 235-44.
 
[18]  Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ 1998; 317: 235-40.
 
[19]  Wilkes MM, Navickis RJ. Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med 2001; 135: 149-64.
 
[20]  Caraceni P, Tufoni M, Bonavita ME. Clinical use of albumin. Blood Transfus 2013; 11(4):18-25.
 
[21]  Melinyshyn A, Callum J, Jeschke MC, Cartotto R. Albumin supplementation for hypoalbuminemia following burns: unnecessary and costly! J Burn Care Res. 2013; 34(1): 8-17.
 
[22]  Boldt J, Heesen m, Muller M, Pabsdorf M, hempelmann G. The effects of albumin versus hydroxyethyl starch solution on cardiorespiratory and circulatory variables in critically ill patients. Anesth Analg 1996; 83: 254-61.