Hypoalbuminemia Affects One Third of Acute Pancreatitis Patients and is Independently associated with Severity and Mortality

Ocskay, Klementina and Vinkó, Zsófia and Németh, Dávid and Szabó, László and Bajor, Judit and Gódi, Szilárd and Sarlós, Patrícia and Czakó, László and Izbéki, Ferenc and Hamvas, József and Papp, Mária and Varga, Márta and Török, Imola and Mikó, Alexandra and Erőss, Bálint and Imrei, Marcell and Hegyi, Péter Jenő and Faluhelyi, Nándor and Farkas, Orsolya and Kanizsai, Péter and Miseta, Attila and Nagy, Tamás and Hágendorn, Roland and Márton, Zsolt and Szakács, Zsolt and Szentesi, Andrea and Hegyi, Péter and Párniczky, Andrea (2021) Hypoalbuminemia Affects One Third of Acute Pancreatitis Patients and is Independently associated with Severity and Mortality. SCIENTIFIC REPORTS, 11. No.-24158. ISSN 2045-2322

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Abstract

The incidence and medical costs of acute pancreatitis (AP) are on the rise, and severe cases still have a 30% mortality rate. We aimed to evaluate hypoalbuminemia as a risk factor and the prognostic value of human serum albumin in AP. Data from 2461 patients were extracted from the international, prospective, multicentre AP registry operated by the Hungarian Pancreatic Study Group. Data from patients with albumin measurement in the first 48 h (n = 1149) and anytime during hospitalization (n = 1272) were analysed. Multivariate binary logistic regression and Receiver Operator Characteristic curve analysis were used. The prevalence of hypoalbuminemia (< 35 g/L) was 19% on admission and 35.7% during hospitalization. Hypoalbuminemia dose-dependently increased the risk of severity, mortality, local complications and organ failure and is associated with longer hospital stay. The predictive value of hypoalbuminemia on admission was poor for severity and mortality. Severe hypoalbuminemia (< 25 g/L) represented an independent risk factor for severity (OR 48.761; CI 25.276-98.908) and mortality (OR 16.83; CI 8.32-35.13). Albumin loss during AP was strongly associated with severity (p < 0.001) and mortality (p = 0.002). Hypoalbuminemia represents an independent risk factor for severity and mortality in AP, and it shows a dose-dependent relationship with local complications, organ failure and length of stay.

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