Albumin to globulin ratio and/or plasma albumin in predicting long-term mortality

Abstract

In a recent study, Azab et al 1 Azab B.N. Bhatt V.R. Vonfrolio S. et al. Value of the pretreatment albumin to globulin ratio in predicting long-term mortality in breast cancer patients. Am J Surg. 2013; 206: 764-770 Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar observed that pretreatment albumin–globulin ratio (AGR) is an independent and significant predictor of long-term mortality in breast cancer patients. These results are interesting in the light of the recent studies 2 Delaney A.P. Dan A. McCaffrey J. et al. The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis. Crit Care Med. 2011; 39: 386-391 Crossref PubMed Scopus (238) Google Scholar , 3 Vincent J.L. Navickis R.J. Wilkes M.M. Morbidity in hospitalized patients receiving human albumin: a meta-analysis of randomized, controlled trials. Crit Care Med. 2004; 32: 2029-2038 Crossref PubMed Scopus (131) Google Scholar , 4 Haynes G.R. Navickis R.J. Wilkes M.M. Albumin administration–what is the evidence of clinical benefit? A systematic review of randomized controlled trials. Eur J Anaesthesiol. 2003; 20: 771-793 Crossref PubMed Google Scholar which showed that use of albumin-containing solutions for the resuscitation of patients with sepsis lowered mortality compared with other fluid resuscitation regimens, although some studies did not support this conclusion. 5 Liberati A. Moja L. Moschetti I. et al. Human albumin solution for resuscitation and volume expansion in critically ill patients. Intern Emerg Med. 2006; 1: 243-245 Crossref PubMed Scopus (38) Google Scholar , 6 Perel P. Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2007; 4: CD000567 PubMed Google Scholar , 7 Wilkes M.M. Navickis R.J. Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med. 2001; 135: 149-164 Crossref PubMed Scopus (397) Google Scholar , 8 Alderson P. Bunn F. Lefebvre C. et al. Human albumin solution for resuscitation and volume expansion in critically ill patients. Cochrane Database Syst Rev. 2004; 4: CD001208 PubMed Google Scholar Since albumin therapy is relatively safe, 7 Wilkes M.M. Navickis R.J. Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med. 2001; 135: 149-164 Crossref PubMed Scopus (397) Google Scholar it would have been interesting had Azab et al 1 Azab B.N. Bhatt V.R. Vonfrolio S. et al. Value of the pretreatment albumin to globulin ratio in predicting long-term mortality in breast cancer patients. Am J Surg. 2013; 206: 764-770 Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar studied whether therapeutic intervention to bring AGR to normal could have improved the survival of the patients. With its ability to expand intravascular volume and correct hypoalbuminemia and both volume expansion and hemodilution are desired in cardiopulmonary bypass surgery and acute ischemic stroke, the beneficial action of albumin is likely in these instances. But, the observation that AGR is an independent predictor of long-term mortality in patients with breast cancer needs to be explained. Value of the pretreatment albumin to globulin ratio in predicting long-term mortality in breast cancer patientsThe American Journal of SurgeryVol. 206Issue 5PreviewPrior studies have demonstrated the prognostic value of pretreatment serum albumin in different types of cancer. The aim of this study was to assess the predictive value of the albumin to globulin ratio (AGR) on survival in breast cancer patients. Full-Text PDF