Early albumin infusion and mortality in elderly patients with sepsis based on analysis of the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database.

Abstract

As the impact of early albumin infusion on the prognosis of elderly individuals diagnosed with sepsis remains uncertain, this study aimed to investigate this effect in elderly patients with sepsis in the intensive care unit (ICU). We identified the information of elderly patients with sepsis requiring ICU admission from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. They were divided into hypoalbuminemia group and control group, and the primary outcome was 90-d mortality. A multivariate logistic regression model and a multivariate Cox proportional-hazards model were used to analyze the correlation between hypoalbuminemia and patient prognosis. Kaplan-Meier survival curve and log-rank test were performed to analyze the survival outcomes. Propensity score matching (PSM) was implemented to determine the precise effect of early albumin infusion on the prognosis of elderly ICU patients with sepsis, and subgroups of patients were identified to explore the factors influencing the relationship. Early hypoalbuminemia was strongly associated with an increased risk of adverse clinical outcomes in elderly patients with sepsis in the ICU. In-hospital mortality (28.6% vs. 19.1%, P<0.001) and 90-d mortality (48.8% vs. 33.4%, P<0.001) were both significantly higher in the early hypoalbuminemia group than in the control group. PSM analysis showed that early albumin infusion was associated with lower in-hospital mortality and 90-d mortality in elderly patients with sepsis combined with hypoalbuminemia in the ICU. Early infusion of albumin could improve patient prognosis and reduce in-hospital mortality and 90-d mortality.