Relationships between human serum albumin levels and septic shock, in-hospital, and out-of-hospital mortality in elderly patients with pneumonia in different BMI ranges.

IF 8.5 Q1 RESPIRATORY SYSTEM
Sha Huang, Lanlan Chen, Ning Yang, Jiao Zhang, Yan Wang, Xiaoyan Chen
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引用次数: 0

Abstract

Objective: This retrospective cohort identified the association of human serum albumin (HSA) with adverse outcomes (septic shock, in-hospital and out-of-hospital mortality) in elderly hospitalized patients who have community-acquired pneumonia (CAP) and specific body mass index (BMI).

Materials and methods: This research included hospitalized CAP individuals (≥ 60 years) and was conducted at a teaching hospital in western China. All the patients were categorized into three populations based on two BMI cutoff values (18.5 kg/m2 and 24 kg/m2). The data was acquired from medical records, local government mortality databases, and telephone interviews. Binomial logistic regression analysis was used to explore the associations between low HSA and septic shock and in-hospital mortality, and Cox regression analysis was used to explore the association between low HSA and out-of-hospital mortality.

Results: A total of 627 patients were included in the analysis of in-hospital death and septic shock, and 431 patients were included in the analysis of out-of-hospital death. The study showed that 120 elderly patients with CAP (19.14%) died in the hospital, while 141 patients (32.71%) died out of the hospital, and 93 patients (14.83%) developed septic shock. No differences in in-hospital and out-of-hospital mortality were observed for BMI values < 18.5 kg/m2 or BMI ≥ 24 kg/m2, regardless of whether HSA was ≥ 40 g/l or < 40 g/l. When 18.5 kg/m2 ≤ BMI < 24 kg/m2, patients with HSA < 40 g/l had both higher in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: 26.13% vs. 11.46%, p < 0.001; out-of-hospital death: 46.15% vs. 19.17%, p < 0.001). No significant differences were observed in the incidence of septic shock between patients with HSA < 40 g/l and those with HSA ≥ 40 g/l either in the overall population or when the BMI values were divided according to the cutoff values of 18.5 kg/m2 and 24 kg/m2. After further logistic regression analysis and adjustment for potential confounders, the results showed that when 18.5 kg/m2 ≤ BMI < 24 kg/m2, elderly CAP patients with HSA < 40 g/l had a higher risk of in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: HR = 1.964, 95%CI = 1.08-3.573; out-of-hospital death: HR = 2.841, 95%CI = 1.745-4.627).

Conclusions: HSA levels can predict the risk of in-hospital and out-of-hospital mortality in elderly patients with CAP and normal BMI values. However, HSA cannot predict the risk of septic shock in elderly patients hospitalized with CAP, irrespective of their BMI classification.

不同体重指数范围的老年肺炎患者血清白蛋白水平与脓毒性休克、院内和院外死亡率之间的关系。
目的这项回顾性队列研究确定了患有社区获得性肺炎(CAP)的老年住院患者的人血清白蛋白(HSA)与不良结局(脓毒性休克、院内和院外死亡率)以及特定体重指数(BMI)之间的关系:研究对象包括住院的 CAP 患者(≥ 60 岁),研究在中国西部的一家教学医院进行。根据两个 BMI 临界值(18.5 kg/m2 和 24 kg/m2)将所有患者分为三个群体。数据来源于医疗记录、当地政府的死亡数据库和电话访谈。二项式逻辑回归分析用于探讨低HSA与脓毒性休克和院内死亡率之间的关系,Cox回归分析用于探讨低HSA与院外死亡率之间的关系:共有 627 例患者纳入院内死亡和脓毒性休克分析,431 例患者纳入院外死亡分析。研究显示,120 名老年 CAP 患者(19.14%)在院内死亡,141 名患者(32.71%)在院外死亡,93 名患者(14.83%)出现脓毒性休克。无论HSA是否≥40 g/l或2≤BMI 2、HSA为2和24 kg/m2的患者,BMI值为2或BMI≥24 kg/m2的患者院内和院外死亡率均无差异。在进一步进行逻辑回归分析并调整潜在的混杂因素后,结果显示,当 18.5 kg/m2 ≤ BMI 2 时,老年 CAP 患者的 HSA 结论:HSA 水平可以预测 BMI 值正常的老年 CAP 患者的院内和院外死亡风险。然而,无论 BMI 分级如何,HSA 都无法预测 CAP 住院老年患者发生脓毒性休克的风险。
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来源期刊
Pneumonia
Pneumonia RESPIRATORY SYSTEM-
自引率
1.50%
发文量
7
审稿时长
11 weeks
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