Association of Hypoalbuminemia within Hospital Mortality in Patients with Acute Decompensated Heart Failure

Abstract

Background: Acute decompensated heart failure (ADHF) remains a leading cause of hospitalization with significant morbidity and mortality. Hypoalbuminemia has been identified as a potential prognostic factor in various medical conditions, including heart failure. Understanding its association with in-hospital mortality in ADHF patients could enhance risk assessment and management strategies. Objective: This study aimed to investigate the association of hypoalbuminemia with in-hospital mortality in patients admitted with ADHF. Methods: This was a retrospective observational study conducted at a tertiary cardiac care center in Rawalpindi between July and November 2023. A total of 480 patients with a confirmed diagnosis of ADHF were included. Inclusion criteria were age ≥ 18 years, confirmed ADHF diagnosis, and available serum albumin levels upon admission. Exclusion criteria included incomplete medical records, end-stage renal disease, active malignancies, acute liver disease, and acute infectious diseases. Data on demographics, clinical characteristics, and serum albumin levels were collected. Logistic regression analysis was used to assess the association between hypoalbuminemia (defined as serum albumin <3.0 g/dL) and in-hospital mortality, adjusting for confounders like age, sex, and comorbidities. Results: The cohort comprised 60% males and 40% females, with a mean age of 68 years. Hypertension (78%), diabetes (42%), and chronic kidney disease (36%) were the most prevalent comorbidities. The mean serum albumin level was 3.2 g/dL (SD = 0.4). Hypoalbuminemia was observed in 42% of patients. In-hospital mortality was 15%. Patients with hypoalbuminemia had a 2.5-fold increased risk of in-hospital mortality (unadjusted HR = 2.5, p < 0.001). The adjusted HR was 2.0 (p < 0.01), indicating hypoalbuminemia as an independent predictor of in-hospital mortality. Conclusion: Hypoalbuminemia is significantly associated with increased in-hospital mortality in patients with ADHF, serving as an independent prognostic indicator. This finding highlights the importance of serum albumin in the risk assessment and management of ADHF patients.