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European Journal of Trauma and Emergency Surgery

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04-07-2023 | Acute Respiratory Distress-Syndrome | Original Article

Hypoalbuminemia: incidence and its impact on acute respiratory distress syndrome and 28-day outcome in trauma patients

Authors: Mandeep Kumar, Kajal Jain, Rajeev Chauhan, Shyam Charan Meena, Ankur Luthra, Haneesh Thakur, Ajay Singh, Revathi Nair, Rekha Gupta

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2023

Abstract

Objective

This prospective observational study explored the effect of early onset hypoalbuminemia (EOH) on the development of adult respiratory distress syndrome (ARDS) in orthopedic trauma victims.

Methods

Serum albumin levels were measured for the initial 7 days of injury for adult trauma patients (18–65 years). Patients were recruited into group A (any serum albumin value < 3.5 mg/dl) and group B (all serum albumin ≥ 3.5 mg/dl), based on serum albumin values. Patients were followed for the development of ARDS and outcome until 28 days. The primary outcome of the study was to explore the effects of EOH on ARDS.

Results

EOH (any serum albumin value < 3.5 g/dl within 7 days of injury) was present in 205/386 (53.1%) patients. The majority of 174/205 (84.9%) patients had EOH by the fourth day after the injury, with the mean time for development of EOH being 2.15 ± 1.87 days. ARDS manifested in 87/205 (42.4%) and 15/181 (8.3%) patients in group A and group B, respectively (p < 0.001). EOH had 8.2 times greater odds of ARDS (OD 8.2 95% CL 4.7–14.0, p = 0.000). The mean time for the onset of ARDS was 5.63 ± 2.62 days. No statistically significant causal relationship occurred between the onset of EOH and the development of ARDS (Pearson’s correlation coefficient = 0.14, p = 0.16). At serum albumin cutoff concentrations of 3.4 gm/dl on D1 (AUC 0.68, 95% CI: 0.61–0.74, p = 0.000), ARDS may be anticipated in 62.8% of patients. The commencement of ARDS was independently correlated with EOH (p = 0.000), Respiratory rate on admission (p = 0.000), inotrope use (p = 0.000), and soft tissue injury (p = 0.000) (R² = 0.466). The odds of 28-day all-cause death were 7.7 times higher in EOH (OD 7.7 95% CL 3.5–16.7, p = 0.00) and 9 times higher in ARDS (OD 9 95% CL 4.9–16.16, p = 0.00).

Conclusion

EOH is a frequent occurrence and has a strong influence development of ARDS and 28-day mortality in trauma patients.

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Title: Hypoalbuminemia: incidence and its impact on acute respiratory distress syndrome and 28-day outcome in trauma patients
Authors: Mandeep Kumar
Kajal Jain
Rajeev Chauhan
Shyam Charan Meena
Ankur Luthra
Haneesh Thakur
Ajay Singh
Revathi Nair
Rekha Gupta
Publication date: 04-07-2023
Publisher: Springer Berlin Heidelberg
Keyword: Acute Respiratory Distress-Syndrome
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-023-02318-5

At a glance: The STEP trials

Springer Medicine

Hypoalbuminemia: incidence and its impact on acute respiratory distress syndrome and 28-day outcome in trauma patients

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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