The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit
The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit
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DOI：
10.1111/j.1365-2044.1996.tb06194.x
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发表时间：
1996-08-01
期刊：
影响因子：
10.7
通讯作者：
Kishen, R
中科院分区：
文献类型：
--
作者：
McCluskey, A;Thomas, AN;Kishen, R
对348例危重病人入院后72小时内连续监测血清白蛋白浓度的预后价值进行了回顾分析。将入院APACHE II(急性生理学和慢性健康评估)评分与入院后不同时间测得的血清白蛋白浓度进行比较，以正确预测患者的预后。多因素Logistic回归分析评估APACHE II和血清白蛋白合并为一个统一的危险指数是否提高了预后的准确性。死亡患者入院时血清白蛋白浓度低于存活患者，且下降速度更快(p<；0.001)。入院时血清白蛋白浓度是一个不敏感的预后指标。然而，24小时后测定的血清白蛋白与入院时的APACHE II评分一样准确，可以根据结果正确地对患者进行分类。入院APACHE II评分与入院后24 h血清白蛋白呈正相关，而与入院血清白蛋白无相关性。将APACHE II评分和系列白蛋白浓度合并到一个统一的死亡风险方程中并不能提高预后预测的准确性。
The prognostic value of serial measurements of serum albumin concentration during the first 72 h after admission to a general adult intensive care unit was retrospectively reviewed in 348 consecutive critically ill patients over a year period. The accuracy of the admission APACHE II (Acute Physiology And Chronic Health Evaluation) score in correctly predicting patient outcome was compared with the serum albumin concentration measured at different times after intensive care unit admission. Multiple logistical regression analyses were performed to evaluate whether combining APACHE II and serum albumin into a unified risk index improved prognostic accuracy. Serum albumin concentration on admission was lower in non-survivors than in survivors and decreased more rapidly in non-survivors (p < 0.001). The admission serum albumin concentration was found to be an insensitive prognostic indicator. However, serum albumin measured after 24 h was as accurate as the admission APACHE II score in correctly classifying patients according to outcome. There was a good correlation between the admission APACHE II score and serum albumin measured after 24 h but not between the admission APACHE II and the admission serum albumin. Combining the APACHE II score and serial albumin concentrations into a unified risk of death equation did not improve the accuracy of outcome prediction.