• Arch Pediatr Adolesc Med · Nov 2007

    Hypoalbuminemia in critically ill children.

    • Ira N Horowitz and Kenneth Tai.
    • Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois, USA. ira.horowitz@atlantichealth.org
    • Arch Pediatr Adolesc Med. 2007 Nov 1;161(11):1048-52.

    ObjectiveTo evaluate whether hypoalbuminemia on admission is a predictor of adverse outcome in critically ill children.DesignRetrospective medical record review.SettingA 14-bed medical and surgical pediatric intensive care unit (PICU).ParticipantsAll patients admitted to the PICU from January 1, 1998, through December 31, 2000, under the care of the PICU team or trauma service and whose albumin level was measured were potential subjects. One hundred fifty-five patients were divided into 4 groups on the basis of age and appropriate albumin level for that age group. The groups of hypoalbuminemic patients were combined (hypoalbuminemia group) and compared with the combined group of patients with albumin levels above the reference cutoff (normal albumin level group).ExposureSerum albumin level.Main Outcome MeasuresLength of PICU and hospital stays, receipt and length of ventilatory support, survival, pediatric risk of mortality score, mortality risk, and number of organ failures.ResultsControlling for mortality risk, the hypoalbuminemia group had a longer average stay in the PICU (8.08 vs 4.41 days; 95% confidence interval [CI] for difference, 1.02-6.32) and the hospital (11.36 vs 6.63 days; 95% CI for difference, 1.31-8.16) than did the normal albumin level group. The hypoalbuminemia group had a lower survival rate (odds ratio, 0.10; 95% CI, 0.02-0.46) and a higher number of organ failures (1.38 vs 0.65; 95% CI for difference, 0.40-1.04).ConclusionAdmission hypoalbuminemia is a significant marker of morbidity and mortality in critically ill children.

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