Serum albumin level and hospital mortality in acute non-ischemic heart failure.
Serum albumin level and hospital mortality in acute non-ischemic heart failure.
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DOI：
10.1002/ehf2.12128
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发表时间：
2017-05
影响因子：
3.8
通讯作者：
Lancellotti P
中科院分区：
文献类型：
--
作者：
Ancion A;Allepaerts S;Oury C;Gori AS;Piérard LA;Lancellotti P
低白蛋白血症在心力衰竭（HF）中很常见，尤其是在老年患者中。它与死亡风险增加有关。本研究旨在检查血清白蛋白水平在预测急性非缺血性HF住院患者死亡率方面的预后意义。我们在546例因急性非缺血性HF入院的患者队列中检查了白蛋白与医院死亡率之间的关系。所有患者均无感染性疾病、重度心律失常（房颤、室性心动过速、室颤）、需要有创通气或急性冠状动脉综合征或原发性瓣膜病。36例患者（7%）在住院期间死亡。这些患者明显年龄较大，（78 ± 9岁vs. 72 ± 12岁; P = 0.006），心率较高（P < 0.0001），肌酐水平升高（P = 0.01），收缩压和舒张压降低（P < 0.05），白细胞计数升高（P = 0.001），白蛋白水平降低（31.3 ± 5.6 g/L vs. 36.9 ± 4.1 g/L; P < 0.001）。多因素分析显示，年龄（P = 0.01）、心率（P < 0.0003）、舒张压（P < 0.01）、白细胞计数（P = 0.009）和血清白蛋白水平（P < 0.0001）是住院死亡率的独立预测因素。低白蛋白血症（<34 g/L）预测住院死亡的敏感性（78.8%）和特异性（75%）最高。入院时测量的血清白蛋白水平可以作为急性非缺血性心力衰竭的简单预后因素。低白蛋白血症与医院死亡风险增加相关，尤其是老年患者。
Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of serum albumin level in the prediction of hospital mortality in patients admitted for acute non‐ischemic HF. We examined the association between albumin and hospital mortality in a cohort of 546 patients admitted for acute non‐ischemic HF. None of the patients had infectious disease, severe arrhythmias (atrial fibrillation, ventricular tachycardia, ventricular fibrillation), required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Thirty‐six patients (7%) died during the hospital stay. These patients were significantly older (78 ± 9 vs. 72 ± 12 years; P = 0.006), had higher heart rate (P < 0.0001), increased creatinine level (P = 0.01), lower systolic and diastolic blood pressures (P < 0.05), elevated leucocyte count (P = 0.001), and lower albumin levels (31.3 ± 5.6 g/L vs. 36.9 ± 4.1 g/L; P < 0.001). With multivariable analysis, age (P = 0.01), heart rate (P < 0.0003), diastolic blood pressure (P < 0.01), leukocyte count (P = 0.009), and serum albumin level (P < 0.0001) emerged as independent predictors of hospital mortality. Hypoalbuminemia (<34 g/L) yielded the best sensitivity (78.8%) and specificity (75%) for predicting hospital death. Serum albumin level measured at admission can serve as a simple prognostic factor in acute non‐ischemic HF. Hypoalbuminemia is associated with increased risk of hospital mortality, especially in elderly patients.