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Role of admission serum albumin levels in patients with intracerebral hemorrhage

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Abstract

Low serum albumin levels have been reported to be an independent predictor of increased morbidity and mortality in multiple disease conditions. The aim of our study was to identify the impact of low serum albumin levels on mortality and outcomes at discharge in patients with intracerebral hemorrhage. We retrospectively reviewed our prospective database of patients with intracerebral hemorrhage from January 2010 to December 2011. Patients were dichotomized into two groups based on their serum albumin levels upon admission. Hypoalbuminemia was defined as serum albumin levels ≤3.4 g/dl. The two groups were compared using Fisher’s exact test for categorical variables and t test for continuous variables. Poor outcome was defined as death or discharge to a long-term nursing facility (modified Rankin Score 4–6). Out of 97 patients admitted with intracerebral hemorrhage, 90 met our inclusion criteria (42 had normal levels and 48 had hypoalbuminemia). The baseline characteristics, risk factors, etiology, location and volume of intracerebral hemorrhage, admission blood glucose, white cell count, length of hospital stay, length of intensive care unit stay, and complications were similar between both groups. Although admission hypoalbuminemia did not impact in-hospital mortality (28 vs 24 %, p = 0.635), there was a significant increase in poor outcomes at discharge (59 vs 31 %, p = 0.009) (OR 1.8; 95 % CI; 1.2–2.8). Similar to other diseases, hypoalbuminemia was associated with poor functional outcomes in patients with intracerebral hemorrhage. This will need to be confirmed in larger prospective studies before adopting therapeutic and preventive strategies in future.

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References

  1. McCluskey A, Thomas AN, Bowles BJ, Kishen R (1996) The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit. Anaesthesia 51:724–727

    Article  CAS  PubMed  Google Scholar 

  2. Ryan TA, Rady MY, Bashour CA, Leventhal M, Lytle B, Starr NJ (1997) Predictors of outcome in cardiac surgical patients with prolonged intensive care stay. Chest 112:1035–1042

    Article  CAS  PubMed  Google Scholar 

  3. Becker BN, Becker YT, Heisey DM, Leverson GE, Collins BH, Odorico JS, D’Alesssandro AM, Knechtle SJ, Pirsch JD, Sollinger HW (1999) The impact of hypoalbuminemia in kidney-pancreas transplant recipients. Transplantation 68:72–75

    Article  CAS  PubMed  Google Scholar 

  4. Vincent JL, Dubois MJ, Navickis RJ, Wilkes MM (2003) Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg 237:319–334

    PubMed Central  PubMed  Google Scholar 

  5. Nicholson JP, Wolmarans MR, Park GR (2000) The role of albumin in critical illness. Br J Anaesth 85:599–610

    Article  CAS  PubMed  Google Scholar 

  6. Demling RH (1986) Effect of plasma and interstitial protein content on tissue edema formation. Curr Stud Hematol Blood Transfus 53:36–52

    Article  PubMed  Google Scholar 

  7. Jorgensen KA, Stoffersen E (1980) On the inhibitory effect of albumin on platelet aggregation. Thromb Res 17:13–18

    Article  CAS  PubMed  Google Scholar 

  8. Dziedzic T, Pera J, Slowik A, Gryz-Kurek EA, Szczudlik A (2007) Hypoalbuminemia in acute ischemic stroke patients: frequency and correlates. Eur J Clin Nutr 61:1318–1322

    Article  CAS  PubMed  Google Scholar 

  9. Cho YM, Choi IS, Bian RX, Kim JH, Han JY, Lee SG (2008) Serum albumin at admission for prediction of functional outcome in ischaemic stroke patients. Neurol Sci 29:445–449

    Article  PubMed  Google Scholar 

  10. Nilsson OG, Lindgren A, Brandt L, Saveland H (2002) Prediction of death in patients with primary intracerebral hemorrhage: a prospective study of a defined population. J Neurosurg 97:531–536

    Article  PubMed  Google Scholar 

  11. Ganti L, Jain A, Yerragondu N, Jain M, Bellolio MF, Gilmore RM, Rabinstein A (2013) Female gender remains an independent risk factor for poor outcome after acute nontraumatic intracerebral hemorrhage. Neurol Res 2013:219097

    Google Scholar 

  12. Ji R, Shen H, Pan Y, Wang P, Liu G, Wang Y et al (2013) A novel risk score to predict 1-year functional outcome after intracerebral hemorrhage and comparison with existing scores. Crit Care 17:R275

    Article  PubMed Central  PubMed  Google Scholar 

  13. Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G (1993) Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke 24:987–993

    Article  CAS  PubMed  Google Scholar 

  14. Stead LG, Jain A, Bellolio MF, Odufuye A, Gilmore RM, Rabinstein A et al (2010) Emergency Department hyperglycemia as a predictor of early mortality and worse functional outcome after intracerebral hemorrhage. Neurocrit Care 13:67–74

    Article  CAS  PubMed  Google Scholar 

  15. Fortes Lima TT, Prandini MN, Gallo P, Cavalheiro S (2012) Prognostic value of intraventricular bleeding in spontaneous intraparenchymal cerebral hemorrhage of small volume: a prospective cohort study. Neurosurgery 70:929–934 discussion 34-5

    Article  PubMed  Google Scholar 

  16. Stein M, Luecke M, Preuss M, Boeker DK, Joedicke A, Oertel MF (2010) Spontaneous intracerebral hemorrhage with ventricular extension and the grading of obstructive hydrocephalus: the prediction of outcome of a special life-threatening entity. Neurosurgery 67:1243–1251 discussion 52

    Article  PubMed  Google Scholar 

  17. Cutting S, Castro C, Lee VH, Prabhakaran S (2014) Impaired renal function is not associated with increased volume of intracerebral hemorrhage. J Stroke Cerebrovasc Dis 23:86–90

    Article  PubMed  Google Scholar 

  18. Sakamoto Y, Koga M, Yamagami H, Okuda S, Okada Y, Kimura K et al (2013) Systolic blood pressure after intravenous antihypertensive treatment and clinical outcomes in hyperacute intracerebral hemorrhage: the stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study. Stroke 44:1846–1851

    Article  CAS  PubMed  Google Scholar 

  19. Babu MS, Kaul S, Dadheech S, Rajeshwar K, Jyothy A, Munshi A (2013) Serum albumin levels in ischemic stroke and its subtypes: correlation with clinical outcome. Nutrition 29:872–875

    Article  CAS  PubMed  Google Scholar 

  20. Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, Tang WW, Methvin A, Smith AL et al (2010) Serum albumin concentration and heart failure risk The Health, Aging, and Body Composition Study. Am Heart J 160:279–285

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Gillum RF, Ingram DD, Makuc DM (1994) Relation between serum albumin concentration and stroke incidence and death: the NHANES I Epidemiologic Follow-up Study. Am J Epidemiol 140:876–888

    CAS  PubMed  Google Scholar 

  22. Toyoda K, Ninomiya T (2014) Stroke and cerebrovascular diseases in patients with chronic kidney disease. Lancet Neurol 13:823–833

    Article  PubMed  Google Scholar 

  23. Toyoda K (2013) Cerebrorenal interaction and stroke. Contrib Nephrol 179:1–6

    Article  PubMed  Google Scholar 

  24. Yahalom G, Schwartz R, Schwammenthal Y, Merzeliak O, Toashi M, Orion D et al (2009) Chronic kidney disease and clinical outcome in patients with acute stroke. Stroke 40:1296–1303

    Article  PubMed  Google Scholar 

  25. Ginsberg MD, Palesch YY, Hill MD, Martin RH, Moy CS, Barsan WG et al (2013) High-dose albumin treatment for acute ischaemic stroke (ALIAS) part 2: a randomised, double-blind, phase 3, placebo-controlled trial. Lancet Neurol 12:1049–1058

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Arkansas for Medical Sciences, 4301W, Markham Street, Slot # 500, Little Rock, AR, 72205, USA

    Kaustubh Limaye & Archana Hinduja

  2. Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Ju Dong Yang

Authors
  1. Kaustubh Limaye
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  2. Ju Dong Yang
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  3. Archana Hinduja
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Correspondence to Archana Hinduja.

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The authors have no conflicts of interest to disclose.

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This study was ethically approved by the Instititutional Review Board at our University.

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Limaye, K., Yang, J.D. & Hinduja, A. Role of admission serum albumin levels in patients with intracerebral hemorrhage. Acta Neurol Belg 116, 27–30 (2016). https://doi.org/10.1007/s13760-015-0504-2

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  • DOI: https://doi.org/10.1007/s13760-015-0504-2

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