Abstract 219: Prognostic Significance of Serum Albumin on Long-Term Mortality in Survivors of Out-of-Hospital Cardiac Arrest

Abstract

Introductions: Hypoalbuminemia is known as a reliable predictor of mortality in patients with various illnesses. However, the prognostic value of serum albumin on out of hospital cardiac arrest (OHCA) patients has not been established. The purpose of study is to investigate whether serum albumin concentration on hospital arrival may be useful in predicting the long-term mortality in survivors from OHCA. Methods: Retrospective analysis of emergency departments OHCA registry from January 2008 to December 2011 has been conducted. The individual medical records were reviewed for the data including Utstein predictors of OHCA, underlying disease, and initial laboratory finding including serum albumin. Primary outcome was survival at 6 months. The secondary outcome was CPC (Cerebral Performance Category) at 6 months. Albumin was categorized as quartiles as < 2.7g/dL, 2.7 to 3.2g/dL, 3.2 to 3.9 g/dL and > 3.9g/dL. Hazard ratios (HRs) were estimated using Cox-proportional hazard models in both univariate and multivariate analysis. All prognostic variables with their p value < 0.1 in univariate analysis were used in multivariate analysis for adjustment. Results: Of 546 OHCA patients, 139 patients had sustained ROSC. Of those, 23 patients (16.5%) survived at 6 month and 16 patients (11.5%) had favorable neurological outcome (CPC 1,2). Survival rate at 6 months were significantly higher in patients with a higher albumin group and neurological outcomes were also more favorable in higher albumin group. In a Cox proportional hazard regression analysis for 6-month survival, patients with lower categories of albumin had increased mortality rates before and after multivariable adjustment. (p value for linear trend < 0.05) Conclusion: Serum albumin is a robust predictor of long-term mortality and associated with neurological outcome in patients with sustained ROSC from OHCA