ArticleThe Southern African journal of critical care : the official journal of the Critical Care Society2020
Low albumin levels are associated with mortality in the critically ill: A retrospective observational study in a multidisciplinary intensive care unit.
Article in The Southern African journal of critical care : the official journal of the Critical Care Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Pooled it
- Construction and validation of a predictive nomogram for 28-day mortality in critically ill patients with toxic encephalopathy.BMC medical informatics and decision making · 2026Article
- Clinical phenotypes of secondary spontaneous pneumothorax (SSP) in different underlying lung diseases: a retrospective study and literature review on the clinical heterogeneity in this single entity.Journal of thoracic disease · 2026Article
- Ultrafiltration in the critically ill patient: a framework for personalized care.Critical care (London, England) · 2026Review
- A common longitudinal intensive care unit data format (CLIF) for critical illness research.Intensive care medicine · 2025Article
- The Impact of Hypoalbuminemia on Inflammatory Markers, Serum Creatinine, Hemoglobin and Outcome in Critically ill Patients With COVID-19 Infection-Retrospective Observation Study.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2025Article
- Predictive Value of IL-6 and PDGF-AA for 28-Day Mortality Risk in Critical Ill Patients.International journal of general medicine · 2025Article
- PPFL: A personalized progressive federated learning method for leveraging different healthcare institution-specific features.iScience · 2024Article
- Elevated Cardiac Troponin Levels as a Predictor of Increased Mortality Risk in Non-Cardiac Critically Ill Patients Admitted to a Medical Intensive Care Unit.Journal of clinical medicine · 2024Article
- Review
- The ongoing challenge of ventilator-associated pneumonia: epidemiology, prevention, and risk factors for mortality in a secondary care hospital intensive care unit.Infection prevention in practice · 2023Article
- Association between ferritin to albumin ratio and 28-day mortality in patients with sepsis: a retrospective cohort study.European journal of medical research · 2023Article
- The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU.Scientific reports · 2023Article
- The Combined Use of Interleukin-6 with Serum Albumin for Mortality Prediction in Critically Ill Elderly Patients: The Interleukin-6-to-albumin Ratio.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Hospital-Wide Protocol Significantly Improved Appropriate Management of Patients withAntibiotics (Basel, Switzerland) · 2022Article
- First 24-Hour Potassium Concentration and Variability and Association with Mortality in Patients Requiring Continuous Renal Replacement Therapy in Intensive Care Units: A Hospital-Based Retrospective Cohort Study.Journal of clinical medicine · 2022Article
- Level of Hypoalbuminemia as a Prognostic Factor in Patients admitted to a Tertiary Care Intensive Coronary Care Unit.Cardiology and cardiovascular medicine · 2022Article
- The role of serum albumin in critical illness, predicting poor outcomes, and exploring the therapeutic potential of albumin supplementation.Science progressArticle
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Albumin is a determinant of plasma colloid oncotic pressure and buffering capacity. It is a carrier protein for drugs and is important for normal functioning of the glycocalyx. Hypoalbuminaemia is common in the critically ill and has been associated with adverse outcomes. The association between hypoalbuminaemia and outcome has not been specifically explored in the South African context. Objectives: To determine whether albumin levels on admission and changes in albumin levels were associated with intensive care unit (ICU) mortality in a heterogenous critically ill population. Methods: This was a retrospective observational study of 247 adult patients who were admitted to a multidisciplinary ICU. Albumin levels were measured on admission and 48 hours later, alongside other biochemical and clinical parameters to determine whether they were predictive of ICU mortality. Results: The lowest level of albumin on admission was 8 g/L and the highest was 43 g/L. The incidence of hypoalbuminaemia (using the laboratory reference range) was 93.9% on admission and 99.4% at 48 hours. Receiver operating characteristic curve analysis provided an optimal albumin cut-off of 18.5 g/L. Using this cut-off, hypoalbuminaemia at admission and at 48 hours was associated with increased ICU mortality. Hypoalbuminaemia at admission was an independent predictor of mortality using multivariable analysis (OR 3.74; 95% confidence interval 1.87 - 4.48). Conclusion: Hypoalbuminaemia is associated with increased ICU mortality. There is currently no evidence to support the use of albumin replacement therapy. Further research is required to determine its role in critically ill patients. Contributions of the study: Hypoalbuminaemia is common in critically ill South African (SA) patients and is associated with increased ICU mortality. This has not been well explored in the SA setting. We found that an optimal albumin cut-off was 18.5 g/L, which was much lower than the limits of the laboratory reference range.
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