Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality
Klementina Ocskay, Zsófia Vinkó, Dávid Németh, L. Szabó, Judit Bajor, Szilárd Gódi, Patrícia Sarlós, László Czakó, Ferenc Izbéki, József Hamvas, Mária Papp, Márta Varga, Imola Török, Artautas Mickevičius, Ville Sallinen, Elena Ramírez‐Maldonado, Shamil Galeev, Alexandra Mikó, Bálint Erőss, Marcell Imrei, Péter Hegyi, Nándor Faluhelyi, Orsolya Farkas, Péter Kanizsai, Attila Miseta, Tamás Nagy, Roland Hágendorn, Zsolt Márton, Zsolt Szakács, Andrea Szentesi, Péter Hegyi, Andrea Párniczky
Abstract
The incidence and medical costs of acute pancreatitis (AP) are on the rise, and severe cases still have a 30% mortality rate. We aimed to evaluate hypoalbuminemia as a risk factor and the prognostic value of human serum albumin in AP. Data from 2461 patients were extracted from the international, prospective, multicentre AP registry operated by the Hungarian Pancreatic Study Group. Data from patients with albumin measurement in the first 48 h (n = 1149) and anytime during hospitalization (n = 1272) were analysed. Multivariate binary logistic regression and Receiver Operator Characteristic curve analysis were used. The prevalence of hypoalbuminemia (< 35 g/L) was 19% on admission and 35.7% during hospitalization. Hypoalbuminemia dose-dependently increased the risk of severity, mortality, local complications and organ failure and is associated with longer hospital stay. The predictive value of hypoalbuminemia on admission was poor for severity and mortality. Severe hypoalbuminemia (< 25 g/L) represented an independent risk factor for severity (OR 48.761; CI 25.276-98.908) and mortality (OR 16.83; CI 8.32-35.13). Albumin loss during AP was strongly associated with severity (p < 0.001) and mortality (p = 0.002). Hypoalbuminemia represents an independent risk factor for severity and mortality in AP, and it shows a dose-dependent relationship with local complications, organ failure and length of stay.