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Serum Albumin as a Biomarker of Poor Prognosis in the Pediatric Patients in Intensive Care Unit

Authors
 Young Suh Kim  ;  In Suk Sol  ;  Min Jung Kim  ;  Soo Yeon Kim  ;  Jong Deok Kim  ;  Yoon Hee Kim  ;  Kyung Won Kim  ;  Myung Hyun Sohn  ;  Kyu-Earn Kim 
Citation
 Korean Journal of Critical Care Medicine, Vol.32(4) : 347-355, 2017-11 
Journal Title
Korean Journal of Critical Care Medicine(대한중환자의학회지)
ISSN
 1229-4802 
Issue Date
2017-11
Keywords
albumins ; intensive care units ; mortality ; pediatrics
Abstract
Background: Serum albumin as an indicator of the disease severity and mortality is suggested in adult patients, but its role in pediatric patients has not been established. The objectives of this study are to investigate the albumin level as a biomarker of poor prognosis and to compare it with other mortality predictive indices in children in intensive care unit (ICU).

Methods: Medical records of 431 children admitted to the ICU at Severance Hospital from January 1, 2012 to December 31, 2015 were retrospectively analyzed. Children who expired within 24 hours after ICU admission, children with hepatic or renal failure, and those who received albumin replacement before ICU admission were excluded.

Results: The children with hypoalbuminemia had higher 28-day mortality rate (24.60% vs. 9.28%, P < 0.001), Pediatric Index of Mortality (PIM) 3 score (9.23 vs. 8.36, P < 0.001), Pediatric Risk of Mortality (PRISM) III score (7.0 vs. 5.0, P < 0.001), incidence of septic shock (12% vs. 3%, P < 0.001), C-reactive protein (33.0 mg/L vs. 5.8 mg/L, P < 0.001), delta neutrophil index (2.0% vs. 0.6%, P < 0.001), lactate level (1.6 mmol/L vs. 1.2 mmol/L, P < 0.001) and lower platelet level (206,000/μl vs. 341,000/μl, P < 0.001) compared to the children with normal albumin level. PIM 3 (r = 0.219, P < 0.001) and PRISM III (r = 0.375, P < 0.001) were negatively correlated with serum albumin level, respectively.

Conclusions: Our results highlight that hypoalbuminemia can be a biomarker of poor prognosis including mortality in the children in ICU.
Files in This Item:
T201706438.pdf Download
DOI
10.4266/kjccm.2017.00437
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Kyu Earn(김규언)
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0002-5634-9709
Kim, Soo Yeon(김수연) ORCID logo https://orcid.org/0000-0003-4965-6193
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Kim, Jong Deok(김종덕)
Sol, In Suk(설인숙) ORCID logo https://orcid.org/0000-0003-2470-9682
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178351
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