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Category: Volume 06 Issue 01 January 2018
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Title: Evaluation of Hypoalbuminemia as a Predictor of Clinical Outcome in Critically Ill Children in Alexandria University Children's Hospital

Authors: Azza A. Moustafa, Aminah S. Al Halawany, Mohamed F. Rafa

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.139

Abstract

Outcome prediction is an important target in intensive care unit for providing information on patient outcomes for clinicians and family of critically ill patients. Hypoalbuminemia on admission is common in critical illness in all populations and proved to be a strong predictor of clinical outcome in adults. Because it is a simple, cheap and sensitive marker, it has been used for several purposes in adult Intensive Care Units (ICU) including outcome prediction. Although hypoalbuminemia is a common finding in critically ill children, there is a lack of data that evaluate its usefulness in predicting clinical outcome. In this retrospective study, we aimed to evaluate hypoalbuminemia as a predictor of clinical outcome in 487 critically ill children admitted to a tertiary hospital. Results showed that hypoalbuminemia was present at admission in 40.66% patients that increased to 53.8% during rest of the PICU stay. Hypoalbuminemia at admission was an independent predictor of mortality. Also, we found that patients with hypoalbuminemia at admission had a significantly higher Pediatric Logistic Organ Dysfunction score (PELOD), prolonged Pediatric Intensive Care Unit (PICU) stay and higher mortality. Patients with hypoalbuminemia during admission had significantly longer length of PICU stay, more need for mechanical ventilation, worse PELOD score, higher Pediatric Index of Mortality 2 (PIM2) score and higher mortality. Thus hypoalbuminemia at admission can be helpful for risk assessment and can be used as an outcome predictor in critically ill children.

Keywords: hypoalbuminemia; serum albumin; clinical outcome; predictor; critically ill children; pediatric intensive care unit (PICU).

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Corresponding Author

Mohamed F. Rafa

Alexandria University

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