Cord Serum Albumin Level Research Articles

Development and validation of early prediction models for new-onset functional impairment of patients with trauma at hospital discharge.

Early identification of individuals at risk of functional impairment after trauma is crucial for the timely clinical decision-making and intervention to improve reintegration into the society. This study aimed to develop and validate models for predicting new-onset functional impairment after trauma using predictors that are routinely collected within 2 days of hospital admission. In this multicenter retrospective cohort study of acute care hospitals in Japan, we identified adult patients with trauma with independence in carrying out activities of daily living before hospitalization, treated in the intensive or high-dependency care unit, and survived for at least 2 days between April 2008 and September 2023. The primary outcome was functional impairment defined as Barthel Index ≤60 at hospital discharge. In the internal validation data set (between April 2008 and August 2022), using the routinely collected 129 candidate predictors within 2 days of admission, we trained and tuned the four conventional and machine learning models with repeated random subsampling cross-validation. We measured the performance of these models in the temporal validation data set (between September 2022 and September 2023). We also computed the importance of each predictor variable in our model. We identified 8,529 eligible patients. Functional impairment at discharge was observed in 41% of the patients (n = 3,506/8,529). In the temporal validation data set, all four models showed moderate discrimination ability, with areas under the curve above 0.79, and extreme gradient boosting showing the best performance (0.83). In the variable importance analyses, age was the most important predictor, followed by consciousness, severity score, cervical spinal cord injury, mild dementia, and serum albumin level at admission. We successfully developed early prediction models for patients with trauma with new-onset functional impairment at discharge that achieved high predictive performance using routinely collected data within 2 days of hospital admission. Prognostic/Epidemiological; Level II.

Association of neonatal hyperbilirubinemia with cord albumin among term appropriate for gestational age neonates

Background: Neonatal hyperbilirubinemia (NH) is the most common abnormality seen during the neonatal period. It affects nearly 60% of term and 80% of preterm neonates during the first week of life. Early discharge of healthy term and late preterm newborns after normal vaginal delivery is a common practice however there are reports of bilirubin induced brain damage (kernicterus) occurring in these infants. Therefore, to ascertain whether cord albumin can be used as a reliable indicator for predicting neonatal hyperbilirubinemia. Methods: A tertiary care hospital-based cross-sectional study was conducted in 142 healthy late preterm and term newborns of either gender with icterus appearing only after 24 hour of life with no other illness using a non-probability sampling method. Data analysis was done using statistical package for the social sciences (SPSS) version 16. Chi-square was used to determine the association between cord albumin and hyperbilirubinemia. Results: There is a significant negative correlation between cord albumin and serum bilirubin at 72-96 hours of life (p=0.001). A total of 142 healthy late preterm and term neonates included. The study group based on Cord serum albumin (CSA) levels ≤2.8 g/dl, 2.9-3.3 g/dl, and ≥3.4 g/dl shows 77.27%, 22.7% and none respectively developed NH requiring phototherapy. According to receiver operating curve (ROC) analysis, the cutoff point of 2.75 g/dl provides the best sensitivity and specificity result. Conclusions: Cord serum albumin level ≥3.4 g/dl are probably safe for early discharge whereas cord serum albumin level <3.4 g/dl will need a close follow-up to check for the development of jaundice.

Cord Blood Albumin as a Predictor of Neonatal Jaundice

Background: Neonatal jaundice is a very common condition worldwide occurring in up to 60% of term and 80% of preterm newborns in the first week of life. Even though extreme hyperbilirubinemia is rare in developed countries it is still quite rife in developing countries often resulting in kernicterus with its attendant medical, economic and social burden on the patient, family and society. Objective: The present study was conducted to evaluate the predictive value of umbilical cord blood albumin level for subsequent neonatal jaundice in healthy full-term neonates. Patients and Methods: The current study was carried out in the Pediatric Department, Faculty of Medicine, Aswan University Hospital. The study was conducted on 100 healthy full-term newborn after obtaining consent from parents. Cord blood was collected at birth and cord blood albumin estimation was done. Results: The incidence of neonatal hyperbilirubinemia in our study (64%). In terms of demographic data: males represented (32.5 %) of the jaundiced cases in the study and females represented (62.5 %); the difference was statistically insignificant (P value 0.325). Cord serum albumin level of (> 3.3) g/dl has a sensitivity of (86%) and specificity of (80%), PPV (81%), NPV of (85%) and the accuracy rate was (83 %) in predicting neonatal hyperbilirubinemia. Conclusion: There is significant correlation between cord serum albumin level and neonatal hyperbilirubinemia in healthy full-term neonates ≥ 2.5 kg birth weight and that serum albumin level taken from the blood of the umbilical cord is an effective way to predict neonatal hyperbilirubinemia in term healthy infants.

A study to determine the level of cord blood albumin in predicting neonatal jaundice

Background: Most unconjugated bilirubin formed by the fetus is cleared by the placenta into the maternal circulation. Albumin constitutes 70 - 75% of Plasma oncotic pressure. Another important function of albumin is its antioxidant property. Bilirubin binds to albumin in an equimolar ratio. Free bilirubin is anticipated when the molar bilirubin- to- albumin (B: A) ratio is >0.8 Objective of the study was to predict the proportion of newborn requiring intervention for NH (phototherapy or exchange transfusion) based on cord serum albumin level at birth.Methods: The present prospective study was conducted at Navodaya Medical College, Raichur from October 2018 to November 2019. A total of 180 babies which were born during the study period were included in the study. INCLUSION CRITERIA• Term babies both genders• Mode of delivery (normal and C-section)• Birth weight ≥2.5kg.• APGAR ≥7/10 at 1 min. Cord Serum Albumin level was estimated at birth. Total Serum Bilirubin (TSB) estimation was done at 72-96 hours of age. All the babies were followed up daily for first 4 postnatal days and babies were daily assessed for NH and its severity.Results: In our study nearly 54.4% of them had Cord Serum Albumin levels of less than 2.8 gm/dl, 27.3% of them had albumin levels of 2.9 to 3.3 gm/dl, 18.3% of them had Serum Albumin of 3.4 gm/dl. Out of 180 study subjects, 13.9% of them required phototherapy to treat neonatal hyper bilirubinemia and 2.8% of the study subjects required exchange transfusion.Conclusions: From the present study, cord serum albumin level of ≤2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So, this ≤2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia.

Predictive value of umbilical cord blood albumin levels as an indicator of neonatal jaundice in healthy term newborns

Background: Neonatal hyperbilirubinemia (NH) is the most common cause of readmission during the early neonatal period. There is a need to find the methods of screening babies at higher risk of developing jaundice before discharge. Objectives: The objectives of this study were to find out the predictive value of cord serum albumin (CSA) levels as an indicator of neonatal jaundice. Materials and Methods: A cross-sectional study conducted at a tertiary hospital of Maharashtra, from October 2017 to September 2019 on 410 term newborns. CSA was collected at birth and correlated with serum bilirubin levels collected at 48 h of life. Statistical analysis was performed and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with a 95% confidence interval obtained. Results: Of 410 cases, 266 (64.8%) developed clinical jaundice, of which 148 (93.6%) had albumin levels <2.8 g/dl, 79 (74.5%) between 2.8 and 3.3 g/dl, and 39 (26.7%) >3.3 g/dl. At CSA level <2.8 g/dl, the sensitivity of 93.67% with PPV and NPV of 51.57% and 94.65%, respectively, was found. At CSA level 2.8–3.3 g/dl, the sensitivity estimated was 85.98% with a PPV and NPV of 85.34% and 74.31%, respectively. Conclusion: In this study, CSA appears to be a risk indicator in predicting neonatal hyperbilirubinemia. CSA level <2.8 g/dl is a high-risk factor for the future development of neonatal hyperbilirubinemia, while those with CSA level >3.3 g/dl are probably safe for early discharge from the hospital.

Cord blood albumin as predictor of neonatal hyperbilirubinemia

Background: Measuring the Cord blood Albumin level and predicting neonatal hyperbilirubinemia.Methods: Prospective study was performed on 160 healthy term neonates. Relevant maternal history was collected. Cord blood was collected from the healthy term neonates at birth and cord serum albumin measured. Neonate was assessed for jaundice every day using transcutaneous bilirubinometer. Total Serum Bilirubin (TSB) was assessed if the Transcutaneous Bilirubin (TCB) values were found high and treated according to NICU protocol.Results: Study cohort was grouped as Group A, Group B and Group C based on Cord Serum Albumin (CSA) level ≤3.3 g/dl, 3.3-3.8 g/dl and ≥3.8 g/d respectively. Statistical analysis was done for correlation of CSA with Neonatal Hyperbilirubinemia (NH). It showed that cord serum albumin level ≤3.8 g/dl is critical, as it was seen in 9.1% of neonates who developed neonatal hyperbilirubinemia (p value-0.032).Conclusions: There is a correlation between cord serum albumin level and neonatal hyperbilirubinemia. Cord serum albumin level of ≤3.8 g/dl is a risk indicator in predicting the development of neonatal hyperbilirubinemia.

Evaluation of the cord blood albumin for the early prediction of neonatal jaundice

Background and Aim: Neonatal Hyperbilirubinemia (NH) is the most common cause for readmission during the early neonatal period. There are reports of bilirubin induced brain damage occurred in healthy term infants even without haemolysis and the sequalae could be serious. Aim of the study was to predict the development of Neonatal Hyperbilirubinemia at birth using Cord Serum Albumin as a risk indicator.Material and Methods: Observation study was performed on 348 healthy term new-borns. Cord blood was collected from the healthy term new-borns delivered either vaginally or caesarean section for cord serum albumin level measurements. Total serum bilirubin and direct serum bilirubin were measured during 72-96 hours of life with serum sampling of peripheral venous blood. Newburn was assessed clinically daily for Neonatal Hyperbilirubinemia or for any other complication during the study period. Results: Study cohort is grouped into Group1, Group2 and Group 3 based on Cord Serum Albumin level 2.8g/dl, 2.9-3.3g/dl and 3.4g/dl, respectively. In these groups, new-borns with total serum bilirubin level 17mg/dl after 72 hours are taken as Neonatal Hyperbilirubinemia, requiring interventions like phototherapy or exchange transfusion. Conclusion: There is a correlation between Cord serum albumin level and neonatal hyperbilirubinemia in healthy term new-borns. Cord serum albumin level of 2.8 g/dl can predict the development of neonatal hyperbilirubinemia.

Association of cord serum albumin with neonatal hyperbilirubinemia among term appropriate-for-gestational-age neonates.

IntroductionNeonatal jaundice affects nearly 60% of term and 80% of preterm neonates during the first week of life. Although early discharge of healthy term newborns is a common practice, neonatal hyperbilirubinemia (NH) is the most common cause for readmission during the early neonatal period.ObjectiveTo determine the association of cord serum albumin with serum bilirubin levels and whether it can be used as a risk indicator for the development of NH.MethodIn this observational study, cord blood was collected from healthy term newborns for serum albumin level measurements. Total serum bilirubin and direct serum bilirubin were measured during 72–96 h of life. Newborns were clinically assessed daily for NH or for any other complication during the study period.ResultAmong the study cohort of 300 babies, 35 had a total serum bilirubin level of ≥17 mg/dl after 72 h and were considered to have NH. They were grouped as Group 1, Group 2, and Group 3 according to the cord serum albumin level ≤2.8 g/dl, 2.9–3.3 g/dl, and ≥3.4 g/dl, respectively. Statistical analysis was conducted to assess the correlation of cord serum albumin with NH. The results showed that a cord serum albumin level ≤2.8 g/dl is critical, as it was seen in 95% of term newborns who developed NH. In the group where cord serum albumin was ≥3.4 g/dl, none of the term newborns developed NH.ConclusionTerm neonates with hyperbilirubinemia with a total serum bilirubin level ≥17 mg/dl had levels of cord serum albumin of ≤2.8 g/dl, and this can be used as a risk indicator to predict the development of NH.

Cord serum albumin as a predictor of neonatal hyper bilirubinemia in healthy full-term neonates

Introduction: Neonatal jaundice or icterus neonatorum is one of the common problem that is seen in newborns during first week of neonatal life. Clinical jaundice is found in about 80% of preterm and in about 60-70% of term neonates. The main objective of the study was to determine the correlation between cord serum albumin levels and development of significant hyper bilirubinemia in healthy term neonates. Methods: A prospective study was conducted on 316 healthy term neonates. Gender, mode of delivery and birth weight were taken into consideration. It was ascertained that there was no other risk factor for neonatal hyperbilirubinemia among these newborns. These neonates were divided into 3 groups, Group A (cord serum albumin levels < 2.8 gm/dl), Group B (cord serum albumin levels between 2.8 to 3.4 gm/dl) and Group C (cord serum albumin levels 3.4 gm/dl). Result: Of the 316 babies included in the study, 102 babies were under Group A, 166 babies under Group B and 48 babies under Group C. 35 babies in Group A, 5 in Group B and none in Group C developed significant hyperbilirubinemia and required phototherapy. The sensitivity and specificity of cord serum albumin level 2.8 g/dl to predict risk of development of significant neonatal hyperbilirubinemia in our study was 87.50% and 75.72% respectively. Conclusion: Cord serum albumin levels can help us to predict the possibility of significant hyperbilirubinemia among neonates. Hence this can help us to identify the at-risk neonates and utilize our limited resources efficiently among these newborns.

Predictive value of umbilical cord blood bilirubin and albumin for significant hyperbilirubinemia in ABO incompatibility

AIM OF THE STUDY: 1. To estimate the levels of bilirubin and albumin in cord blood. 2. To estimate the relationship between cord blood bilirubin and occurrence of neonatal hyperbilirubinemia. 3. To estimate the relationship between cord blood albumin and occurrence of neonatal hyperbilirubinemia. METHODOLOGY: This prospective study was conducted in Rajah Mirasudhar Hospital, attached to Thanjavur Medical College, Thanjavur, during the period of Feburary 2017 to July2017. The study sample consisted of 55 healthy term newborn babies with blood group O +ve born to O +ve mothers as control and 37 healthy term newborns with blood group A +ve or B +ve born to O +ve mothers as case group. Umbilical cord blood was collected from newborns and serum albumin and bilirubin levels estimated. Relevant history was obtained from mother and maternal hospital records. The babies were followed-up daily for development of jaundice and serum bilirubin was measured in all newborns at 24 and 72 hours of life. RESULTS: 1. The mean serum total bilirubin in umbilical cord blood was 1.596+0.46 mg/dl in control group and 1.995+1.16 mg/dl in case group. 2. The umbilical cord serum albumin and total bilirubin correlates well with the development of significant neonatal hyperbilirubinemia requiring treatment in the form of phototherapy with or without exchange transfusion. 3. Umbilical cord serum albumin level of less than or equal to 3.15 g/dl predicts the development of significant hyperbilirubinemia with a sensitivity of 76.5%, specificity of 78.7% and an accuracy of 77.6%. The accuracy of prediction of significant hyperbilirubinemia by cord serum albumin is higher for babies with ABO incompatibility when compared with control group. 4. Umbilical cord serum total bilirubin of more than or equal to1.85 mg/dl predicts the development of significant hyperbilirubinemia with a sensitivity of 70.6%, specificity of 82.7% and an accuracy of 76.7%. CONCLUSION: 1. In ABO blood group incompatibility, neonates with umbilical cord blood total bilirubin >1.85 mg/dl and albumin 3.15 g/dl can be safely discharged early. 2. Hence, we recommend routine measurement of serum bilirubin and albumin levels in umbilical cord blood at birth to predict those newborns at risk of developing significant hyperbilirubinemia requiring treatment in the form of phototherapy with or without exchange transfusion.

Role of cord blood bilirubin and albumin levels as predictors of subsequent hyperbilirubinemia in newborns

Introduction: Neonatal hyperbilirubinemia is one of the most common problems in term and preterm babies. Development of hyperbilirubinemia in neonates is fretful for the parents and a concern for the pediatrician too. Healthy babies born through normal vaginal delivery who are getting discharged early are being readmitted for the treatment of hyperbilirubinemia. Aim sand Objectives: The present study is done to determine the correlation of cord blood bilirubin, albumin and neonatal hyperbilirubinemia in identifying newborn babies at risk of developing significant hyperbilirubinemia and to establish the cutoff values of cord blood bilirubin and cord blood albumin levels to identify such high-risk neonates. Materials and Methods: In present study, 303 term neonates who are delivered in ASRAM, Eluru from January 2012-January 2013, were included after parental consent. Cord blood bilirubin, Blood grouping and typing, Cord blood albumin and serum bilirubin levels were done in all babies. Results: The incidence of significant hyperbilirubinemia in this study was 23.7%. Cord serum unconjugated bilirubin level ≥2.0 mg/dl and total cordserum bilirubin level ≥ 2.5mg/dl as high risk indicator towards predicting neonatal hyperbilirubinemia in first week of life. 58.53% babies had cord serum albumin level &lt; 2.8gm/dl. Conclusion: Cord serum unconjugated bilirubin level ≥2mg/dl and total cord serum bilirubin level ≥2.5mg/dl, cord blood albumin &lt;2.8g/dl is a high-risk indicator towards predicting neonatal hyperbilirubinemia in the first week of life.

Low Cord Serum Albumin is A Risk Indicator in Predicting Neonatal Jaundice.

Objective: 1.Measuring the Cord Serum Albumin level (CSA) in predicting neonatal hyperbilirubinemia. Method: Prospective study was performed on 100 healthy term neonates. Relevant maternal history is collected. Cord blood was collected from the healthy term neonates at birth, CSA measured. Neonate was assessed clinically every day. Total Serum Bilirubin (TSB) and blood group were assessed in neonate during 7296 hours of life. TSB value ≥15mg/dl is considered Neonatal Hyperbilirubinemia (NH) which requires intervention like phototherapy (PT) or Exchange transfusion (ExT). Result: Study cohort is grouped in Group 1, Group 2 and Group 3 based on Cord Serum Albumin level ≤2.8g/dl, 2.9-3.3g/dl and ≥3.4g/dl, respectively. Statistical analysis was done for correlation of CSA with NH. It showed that cord serum albumin level ≤2.8g/dl is critical, as it was seen in 90% of neonates who developed neonatal hyperbilirubinemia. Conclusion: There is a correlation between Cord serum albumin level and neonatal hyperbilirubinemia. Cord serum albumin level of ≤2.8 g/dl is a risk indicator in predicting the development of neonatal hyperbilirubinemia at birth.

English

OBJECTIVE: 1. Comparing Cord Serum Albumin level (CSA) with Cord Serum Bilirubin (CSB) in predicting neonatal hyperbilirubinemia. 2. To know the sensitivity, specificity, Positive predictive value and negative predictive value of CSA and CSB in predicting neonatal jaundice in term neonates. METHOD: Prospective study was performed on 174 healthy term neonates. Relevant maternal history is collected. Cord blood was collected from the healthy term neonates at birth, CSA and CSB measured. Neonate was assessed clinically every day. Total Serum Bilirubin (TSB) and blood group were assessed in neonate during 72-96 hours of life. TSB value ≥17mg/dl is considered Neonatal Hyperbilirubinemia (NH) which requires intervention like phototherapy (PT) or Exchange transfusion (ExT). RESULT: Study cohort is grouped in Group 1, Group 2 and Group 3 based on Cord Serum Albumin level ≤2.8g/dl, 2.9-3.3g/dl and ≥3.4g/dl, respectively. Based on CSB, study cohort divided into neonates with CSB ≤ 2mg/dl and CSB ≥ 2.1mg/dl. Statistical analysis done for correlation of CSA and CSB with NH. Statistical significance is seen for both CSA and CSB. CONCLUSION: Both CSA and CSB are equally effective in predicting NH at birth. These study variables can be considered as neonatal screening tool for NH for term neonates.