Phenotype-specific dynamics of serum albumin and their impact on sepsis mortality.

IF 1.9 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Biomarkers in medicine Pub Date : 2025-06-18 DOI:10.1080/17520363.2025.2521251

Gianni Turcato, Arian Zaboli, Lucia Filippi, Paolo Ferretto, Daniela Milazzo, Michael Maggi, Alessandro Cipriano, Massimo Marchetti, Lorenzo Ghiadoni, Christian J Wiedermann

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引用次数: 0

Abstract

Aims: To assess the prognostic value of serial serum albumin measurements in septic patients, with a focus on different clinical phenotypes.

Methods: We conducted a prospective observational study involving 254 patients with sepsis admitted to an Intermediate Care Unit in Italy (September 2022-June 2024). Patients were classified into four sepsis phenotypes (α, β, γ, δ), and serum albumin levels were measured daily over five days. The primary outcome was 30-day mortality. Logistic regression, Cox models, and AUROC analysis were used to evaluate associations between albumin dynamics, phenotypes, and outcomes.

Results: The δ phenotype showed the lowest mean albumin levels (2.2 g/dL) and the highest mortality (45.4%), while phenotype α had the highest albumin and lowest mortality (3.6%). Each 1 g/dL increase in albumin was associated with a 63% mortality risk reduction (HR 0.37; 95% CI: 0.24-0.56). Albumin's predictive performance was strongest in the δ phenotype (AUROC up to 0.95).

Conclusion: Serial albumin monitoring may provide prognostic insights in sepsis, especially in phenotypes associated with endothelial dysfunction. These results are hypothesis-generating and may support more personalized treatment strategies.

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血清白蛋白的表型特异性动态及其对败血症死亡率的影响。

目的：评估系列血清白蛋白测量在脓毒症患者的预后价值，重点关注不同的临床表型。方法：我们进行了一项前瞻性观察研究，纳入了意大利一家中级护理病房收治的254例败血症患者（2022年9月至2024年6月）。将患者分为四种脓毒症表型（α, β, γ, δ），并在五天内每天测量血清白蛋白水平。主要终点为30天死亡率。使用逻辑回归、Cox模型和AUROC分析来评估白蛋白动力学、表型和结果之间的关系。结果：δ表型的白蛋白水平最低（2.2 g/dL），死亡率最高（45.4%），α表型的白蛋白水平最高，死亡率最低（3.6%）。白蛋白每增加1 g/dL，死亡风险降低63% (HR 0.37；95% ci: 0.24-0.56)。白蛋白对δ表型的预测效果最强（AUROC高达0.95）。结论：连续白蛋白监测可能为脓毒症的预后提供见解，特别是与内皮功能障碍相关的表型。这些结果是假设产生的，可能支持更个性化的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomarkers in medicine 医学-医学：研究与实验

CiteScore

3.80

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.