A study of Serum Albumin level and it’s association in cure in chronically ill patients

Abstract

Background: In cases of a pathological state there might be a low formation of the albumin in liver or high degradation of the albumin. In either of the ways the serum albumin will be lowered. Stress and strain is also known to cause hypoalbuminemia i.e low serum level of albumin. Since albumin is a protein it has to be transcribed rom the genes and studies have shown that TNF - alpha supresses this transcription process. The TNF – alpha is known to increase in any inflammation and thus forms a cascade. In case of hospitalised patients the stress and strain in pre surgical patients and chronically hospitalised patients the serum albumin levels are known to be less than normal. In chronically hospitalised patients the nutritional cause can also be taken into consideration for lower serum albumin levels. Early detection of these low levels of serum albumin levels helps the the physicians to intervene and thus cut off the progression of the disease. A sincere effort has been made in this study to understand the relations of the serum albumin level and its effects on the prognosis of the chronic diseases and outcome of the treatment if the patient is undergoing any. This study is intended to help the physician, surgeon and general practitioners to understand and intervene in the event and thus help the patient to recover earlier and in a better way. Aim of the study: is to estimate the mean serum albumin levels in hospitalised patients, to estimate the mean serum albumin levels in patients undergoing surgery and to correlate the serum albumin levels and the prognosis of the patient. Methods: This study was done in the Department of General Medicine at Kanachur Institute of Medical Sciences, Mangalore. This study was done from Jan 2017 to Dec 2018 The study is a cross – sectional study. The study is also double blinded and randomised. The study is a multi - level study. The sample size included one hundred patients. One hundred patients were identified in the department of Medicine. The patients were either chronically ill who were hospitalised for more than three weeks or who were undergoing treatment. The serum albumin levels were estimated. In chronically hospitalised patients the patients were divided into three groups 1. Serum levels less than 2 gm / Dl 2. Serum levels between 2 g/ dl and 5 gm / Dl 3. Serum levels more than 5 gm / Dl The serum albumin levels were again estimated and the prognosis was checked in the form of pain, worsening of symptoms, positive progression of disease, cure and death. In each group the necessary treatment was given in the form of nutrition supplementation and was observed for the prognosis. The serum albumin levels were again estimated and the prognosis was checked in the form of pain, worsening of symptoms, positive progression of disease, cure and death. Result: In the present study there is a significant difference in the prognosis of the patients when the serum albumin level increases in the serum. The mean serum levels in the three groups were found to be 1.95 gm / Dl, 2.85 gm / Dl and 5.1 gm / Dl. In the third group the cure was complete with treatment, showing the significance of serum albumin levels in the prognosis and outcome of the disease. Conclusion: The disease prognosis was significantly altered when the low serum albumin was altered.