“ASSOCIATION OF SERIAL SERUM ALBUMIN TRENDS WITH CLINICAL OUTCOMES IN CRITICALLY ILL MEDICAL PATIENTS"
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Keywords
Serum albumin, hypoalbuminemia, critical illness, prognostic marker, mechanical ventilation, ICU mortality
Abstract
Serum albumin is a well-recognized indicator of nutritional status, systemic inflammation, endothelial integrity, and overall physiological reserve. In critically ill patients, hypoalbuminemia is common due to increased capillary leakage, reduced synthesis, and heightened catabolism. Serial serum albumin measurements may therefore serve as a simple, cost-effective prognostic marker, particularly in resource-limited intensive care settings.
Aim: To evaluate the prognostic significance of baseline and serial serum albumin levels in critically ill patients admitted to the MICU/ICCU of Himalaya Medical College, Patna.
Methods: This prospective observational study included 100 critically ill medical patients admitted between January and September 2025. Serum albumin levels were measured on admission (Day 0) and serially on Days 1, 3, 5, 7, and 10. Patients were categorized as survivors and non-survivors based on in-hospital mortality. Outcomes assessed included mortality, need for mechanical ventilation, duration of ventilation, and length of hospital stay. Statistical analysis was performed using Chi-square and Student’s t-tests.
Results: Of the 100 patients, 64% were male and 72% survived. Hypoalbuminemia (<3.5 g/dL) at admission was significantly more common in non-survivors (92.9%) than in survivors (41.7%) (p = 0.002). Serial albumin levels showed a progressive rise in survivors but a continuous decline in non-survivors (p < 0.001 at all time points). Among patients requiring mechanical ventilation, 75% had admission hypoalbuminemia compared with 50% in the non-ventilated group (p = 0.03). Prolonged ventilation (>10 days) occurred exclusively in non-survivors (39.3%). Length of hospital stay did not significantly differ between survivors and non-survivors (p = 0.41).
Conclusion: Both admission hypoalbuminemia and declining serial serum albumin levels were strong predictors of mortality in critically ill patients. Low albumin levels also correlated significantly with the need for and duration of mechanical ventilation. Routine serial monitoring of serum albumin is an inexpensive, accessible, and valuable tool for early risk stratification and prognostication in ICU settings, especially in resource-limited environments.
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Dr. Pavan D. Patel
Assistant Professor, Department of Medicine, Himalaya Medical College, Patna, Bihar, India.
Dr. Dahya bhai M. Patel
Associate Professor & Consultant, Shraddha Multi speciality Hospital, Surat, Gujarat, India.
Kinnary Shethna
Dietician, Shraddha Multi speciality Hospital, Surat, Gujarat, India.
Dr. Zeel Patel
Resident, Shraddha Multi speciality Hospital, Surat, Gujarat, India.
Priyanshi Kamalia
Student, Fountainhead School, Surat, Gujarat, India.