Abstract
The aim of this study is to evaluate the effectiveness of albumin infusion in critically ill geriatric patients and discuss the prognostic impact on mortality. This study is a retrospective analysis of patients with hypoalbuminemia (â¤2.5 g/dl) over 65 years and older followed-up in a 38-bed-mixed medical-surgical tertiary intensive care unit (ICU) of a 650-bed-academic hospital affiliated to University of Health Sciences in Ä°stanbul during 1-year-period. We collected the data including sex, cause of admission, length of stay, duration of mechanical ventilation and APACHE II scores from patientsâ medical records. The amount of albumin infused per patient and laboratory evaluation concerning albumin levels was processed by hospital electronic database. Overall 200 patients were included study. Among the patients, 90 (45%) were female, and 110 (53.5%) were male with overall mean age of 78.62±7.63 years. The cause of admission was due to non-surgical reasons in 119(59.5%) patients. Mean length of stay and mechanical ventilation time was significantly higher in non-survivors. The amount of albumin used per patient was similar in both study groups (p=0.276). Pretreatment level of serum album was 2.15±0.28 g/dl and 2.10±0.31 g/dl in both groups respectively (p=0.364) having no significant increase after treatment (p=0.352). In the non-survivors group, APACHE II score was significantly high. Long-term mortality ratio was significantly high which indicated that albumin had no beneficial effect on long-term mortality. The albumin transfusion in critically ill patients over 65 years old has no considerable effect on the treatment of hypoalbuminemia and ICU mortality.
Highlights
The population of ‘older person’ aged 60 years and above increased from 9.2% to 11.7% from 1990 to 2013 and this ratio is expected to reach to 21.1% until 2050 [1]
The aim of this study is to evaluate the effectiveness of albumin infusion in critically ill geriatric patients and discuss the prognostic impact on mortality
Albumin is widely used as a resuscitation fluid in heterogeneous groups of critically ill patients but it may not be appropriate in all patients even it may be harmful
Summary
The population of ‘older person’ aged 60 years and above increased from 9.2% to 11.7% from 1990 to 2013 and this ratio is expected to reach to 21.1% until 2050 [1]. Parallel to the global aging, in Turkey, the proportion of citizens aged over 65 years is expected to reach from 7.5% to 10.2% by 2023, 21% by 2050 and 28% by 2075 [2] This dramatic increase results in the many geriatric patients requiring hospitalization and critical care settings. Albumin is an acute-phase protein synthesized by the liver and responsible for transport of various crucial substances and maintenance of normal plasma colloid oncotic pressure by antithrombotic effect [3]. It binds reversibly with drugs, hormones, bilirubin and metal ions and plays an important role in volume expansion and scavenging of free radicals [4]
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