• Burns · May 2020

    Early hypoalbuminemia is associated with 28-day mortality in severely burned patients: A retrospective cohort study.

    • Christian de Tymowski, Simon Pallado, James Anstey, François Depret, Nabilla Moreno, Mourad Benyamina, Alexandru Cupaciu, Marion Jully, Haikel Oueslati, Alexandre Fratani, Maxime Coutrot, Maité Chaussard, Lucie Guillemet, Emmanuel Dudoignon, Maurice Mimoun, Marc Chaouat, Alexandre Mebazaa, Matthieu Legrand, Sabri Soussi, and PRONOBURN group.
    • Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation CRI, Paris, France; Laboratoire d'Excellence (Labex) Inflammex, ComUE Sorbonne Paris Cité, Paris, France. Electronic address: chrisdetymowski@gmail.com.
    • Burns. 2020 May 1; 46 (3): 630-638.

    BackgroundHypoalbuminemia is a frequent condition in the first 24 h after a severe burn injury and is associated with worse outcomes.MethodologyWe investigated the relation between very early hypoalbuminemia (<6 h after admission) and clinical outcome in a retrospective cohort admitted to our unit for severe burn injuries between 2012 and 2017.Results73 severely burned patients were included, with a delay of admission of 3 (2-4) h. In a context of early exogenous supply of albumin, admission and 4H Albuminemia (Alb4 h) were significantly lower in deceased patients (respectively, 34 (29-37) vs 27 (23-30) g/l; p = 0.009 and 27 (24-32) vs 21 (17-27) g/l; p = 0.022) whereas albuminemia ≥6 h were not. The best threshold value of Alb4 h to discriminate 28-day mortality was 23 g/l. Patients with an Alb4 h < 23 g/l had a higher 28-day mortality than patients with an Alb4 h ≥ 23 g/l (42% vs 11%; p = 0.003); adjusted OR = 4.47 (95% CI 1.15-17.36); p = 0.03.ConclusionIn severely burned patients receiving early albumin supply, early hypoalbuminemia is associated with higher mortality whereas later albuminemia (≥6 h) is not. Exploration of whether early albumin infusion (8-12 h post injury) may alter clinical outcome is warranted.Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.

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