Association Between Serum Albumin and the Length of Hospital Stay Among Patients With Acute Heart Failure.

Biological research for nursing Pub Date : 2025-01-01 Epub Date: 2024-06-13 DOI:10.1177/10998004241262530

Sunita Pokhrel Bhattarai, Dillon J Dzikowicz, Mary G Carey

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Abstract

Introduction: Albumin plays a vital role in improving osmotic pressure and hemodynamics. A lower serum albumin level may cause pulmonary congestion and edema and contribute to myocardial dysfunction, diuresis resistance, and fluid retention in acute heart failure. Hypothesis: We hypothesized that AHF patients with normal serum albumin have shorter hospital stays. Methods: Using Electronic Medical Records, patients admitted from May 2020 through May 2021 aged >18, ICD-10, and positive Framingham Heart Failure Diagnostic Criteria were included. We excluded patients without albumin records and eGFRs less than 30 mL/min/1.73 m². Prolonged hospitalization was defined as >8 days of hospitalization. Results: During index emergency department visits, patients were symptomatic (New York Heart Association), aged median of 70 years (Interquartile range (IQR) 18), 59% (n = 103) were male, predominantly White (73%, n = 128), and had a high Charleston Comorbidity index score [5, IQR (4-7)]. Nearly one-fourth (23%, n = 41) of the patients had <3.5 g/dL albumin levels. The median length of hospital stay was eight days (IQR of 11). Comparing differences between lengths of hospital stays (<8 vs. >8 days), there was different serum albumin (3.9 + 0.48 vs. 3.6 + 0.53, p < .001) and left ventricular ejection fraction (45% (range 26-63) versus 30% (range 24-48), p = .004). An increased serum albumin decreased prolonged hospitalization (odds ratio (OR), 0.28; 95% confidence interval (CI), 0.14-0.55, p = <0.001). Patients in the lower albumin group had higher NT-proBNP (median: 8521 (range 2025-9134) versus 5147 (range 2966-14,795) pg/ml, p = .007) and delay in administering intravenous diuretics (391 (167-964) minutes versus 271 (range 157-533) minutes, p = .02). Conclusion: Hypoalbuminemia is strongly associated with prolonged hospitalization. Timely and effective diuretic therapy may reduce hospital stay durations, particularly with albumin supplementation.

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急性心力衰竭患者血清白蛋白与住院时间的关系

简介白蛋白在改善渗透压和血液动力学方面发挥着重要作用。血清白蛋白水平降低可能导致肺充血和水肿，并导致急性心力衰竭患者心肌功能障碍、利尿阻力和体液潴留。假设我们假设血清白蛋白正常的急性心力衰竭患者住院时间较短。方法：使用电子病历使用电子病历，纳入 2020 年 5 月至 2021 年 5 月期间入院的年龄大于 18 岁、符合 ICD-10 和 Framingham 心衰诊断标准的患者。我们排除了无白蛋白记录和 eGFR 小于 30 mL/min/1.73 m2 的患者。住院时间超过 8 天定义为长期住院。结果在急诊科就诊期间，患者均有症状（纽约心脏协会），年龄中位数为 70 岁（四分位距 (IQR) 18），59%（n = 103）为男性，主要为白人（73%，n = 128），查尔斯顿疾病指数评分较高 [5，IQR (4-7)]。近四分之一（23%，n = 41）的患者住院时间为 8 天 vs. >8天），血清白蛋白（3.9 + 0.48 vs. 3.6 + 0.53，p < .001）和左室射血分数（45%（范围 26-63） vs. 30%（范围 24-48），p = .004）不同。血清白蛋白升高可缩短住院时间（几率比（OR），0.28；95% 置信区间（CI），0.14-0.55，p = p = .007）和静脉注射利尿剂的延迟时间（391 (167-964) 分钟对 271（范围 157-533）分钟，p = .02）。结论低白蛋白血症与住院时间延长密切相关。及时有效的利尿剂治疗可缩短住院时间，尤其是在补充白蛋白的情况下。

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Biological research for nursing

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