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Early Hypoalbuminemia is an Independent Predictor of Mortality in Aneurysmal Subarachnoid Hemorrhage

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Abstract

Background

Hypoalbuminemia has been identified as a predictor of morbidity and mortality in critically ill patients. There is very little data on the significance and the prognostic value of hypoalbuminemia in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study analyzed the impact of hypoalbuminemia on patient presentation, complications, and outcomes.

Methods

Records of patients admitted with aSAH were examined. Data on baseline characteristics, prevalence of delayed cerebral ischemia, and discharge outcomes were collected. Multivariable logistic regression analysis was performed to assess for associations.

Results

One-hundred and forty-two patients comprised the study cohort (mean age 54.6 ± 13.4), among which 45 (31.5 %) presented with hypoalbuminemia. No difference in baseline characteristics was noted between patients with hypoalbuminemia and those with normal serum albumin. The overall hospital mortality rate was significantly higher in patients with hypoalbuminemia, compared to those with normal albumin (28.9 % vs. 11.3 %; p = 0.04). Hypoalbuminemia was neither associated with delayed cerebral ischemia nor disability at discharge, but independently associated with in-hospital death (odds ratio: 4.26, 95 % confidence interval: 1.09–16.68; p = 0.04).

Conclusion

In patients with aSAH, early hypoalbuminemia is an independent predictor of hospital mortality but not disability at discharge.

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Authors and Affiliations

  1. Division of Cerebrovascular Diseases, Department of Neurology, School of Medicine, Medical Arts & Research Center, University of Texas Health Science Center, 8300 Floyd Curl Drive, MC 7883, San Antonio, TX, 78229, USA

    Réza Behrouz, Christopher Hans Topel, Lee A. Birnbaum & Vivek Misra

  2. The Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina

    Daniel A. Godoy

  3. Department of Neurological Surgery, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA

    Lee A. Birnbaum, Jean-Louis Caron, Ramesh Grandhi, Jeremiah N. Johnson & Ali Seifi

  4. Department of Medical Informatics, University Hospital, San Antonio, TX, USA

    Kathleen Urbansky

  5. Neurological Service, San Camillo de’ Lellis General Hospital, Rieti, Italy

    Mario Di Napoli

  6. Neurological Section, SMDN—Center for Cardiovascular Medicine and Cerebrovascular Disease, Sulmona, L’Aquila, Italy

    Mario Di Napoli

Authors
  1. Réza Behrouz
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  2. Daniel A. Godoy
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  3. Christopher Hans Topel
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  4. Lee A. Birnbaum
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  5. Jean-Louis Caron
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  6. Ramesh Grandhi
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  7. Jeremiah N. Johnson
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  8. Vivek Misra
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  9. Ali Seifi
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Correspondence to Réza Behrouz.

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Behrouz, R., Godoy, D.A., Topel, C.H. et al. Early Hypoalbuminemia is an Independent Predictor of Mortality in Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 25, 230–236 (2016). https://doi.org/10.1007/s12028-016-0259-5

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  • DOI: https://doi.org/10.1007/s12028-016-0259-5

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