Serum Albumin Values Research Articles

Association of malnutrition with surgical outcomes after spine surgery for spinal epidural abscess.

Malnutrition is a predictor of poor surgical outcomes, but its specific effects in spinal epidural abscess (SEA) are understudied. This study aims to assess the association between nutritional status and post-operative outcomes. We conducted a retrospective cohort study using the 2011-2022 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database to identify adult SEA patients who underwent spinal surgery. The study population was divided into two groups: Nourished (preoperative serum albumin values ≥ 3.5 g/dL) and Malnourished (preoperative serum albumin values < 3.5 g/dL). Multivariable logistic regression analyses were performed to identify factors associated with extended length of stay (LOS), adverse events (AEs), non-routine discharge (NRD), 30-day unplanned reoperation, and mortality. 1462 patients were identified and stratified by nutrition status: 300 Nourished (20.5 %) and 1162 Malnourished (79.5 %). Patients in the Malnourished cohort had a significantly higher incidence of severe medical AEs (Nourished: 42.7 % vs. Malnourished: 55.9, p < 0.001). The Malnourished cohort also had significantly increased LOS (Nourished: 11.0 ± 7.4 days vs. Malnourished: 16.0 ± 11.8 days, p< 0.001), NRD (Nourished: 50.3 % vs. Malnourished: 72.5%, p < 0.001), 30-day mortality (Nourished: 2.0% vs. Malnourished: 4.8 %, p = 0.031), and 30-day reoperation (Nourished: 9.3 % vs. Malnourished: 16.5 %, p = 0.002). On multivariable analysis, malnourishment was an independent predictor of extended LOS [OR: 2.47 (CI: 1.65-3.71), p< 0.001], AEs [OR: 1.41 (CI: 1.08-1.83), p = 0.011], and NRD [OR: 1.93 (CI: 1.44-2.58), p < 0.001], but not 30-day unplanned reoperation or mortality. Our study suggests that malnourishment may be associated with worse post-surgical outcomes for SEA patients.

P1148 The incidence and predictive factors of thromboembolism during hospitalizations for IBD flare-ups: A retrospective cohort study in Taiwan

Abstract Background Thromboembolism (TE) notably increase morbidity and mortality among inflammatory bowel disease (IBD) patients. Despite ECCO's 2024 guidelines advocating routine anticoagulant prophylaxis, its application in Asia remains inconsistent due to a lack of regional studies. This research investigates the incidence and predictors of TE during IBD-related hospitalizations in Taiwan, aiming to improve prevention strategies. Methods Our retrospective cohort study included 282 adult IBD patients, accounting for 515 flare-up related hospitalizations at Linkou Chang Gung Memorial Hospital from January 2001 to March 2024. Patients were classified into two groups based on the occurrence of TE. Numerical data were presented as means ± standard deviations, and categorical data were expressed as absolute numbers and percentages. Data analysis involved chi-square or Fisher's test for categorical variables and the Mann-Whitney U test for continuous variables. Multivariable logistic regression was utilized to identify independent predictors of TE. The cutoff values for serum albumin were determined using receiver operating characteristic (ROC) curves. Statistical significance was set at P &amp;lt; 0.05. All statistical analyses were performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). Results The incidence of TE was 1.55%. The TE group had significantly lower body weight (p=0.02), body mass index (BMI) (p=0.019), hemoglobin (p=0.036), and albumin levels (p=0.001) but higher rate of sepsis (p=0.002) and concurrent autoimmune diseases (p=0.002) compared to the non-TE group. Multivariate analysis indicated that concurrent autoimmune diseases (OR: 0.001, 95% CI: 0.000-0.317, p=0.02) and hypoalbuminemia (OR: 0.031, 95% CI: 0.001-0.643, p=0.025) were independent predictors of TE. (Table 1) The optimal serum albumin cutoff was established at 3.01 g/dL, with sensitivities and specificities of 87.5% and 77.3%, respectively. (Figure 1) Conclusion This pioneering Asian study identifies concurrent autoimmune diseases and low serum albumin (&amp;lt; 3.01g/dL) as independent predictors of TE in hospitalized IBD patients. Prophylactic anticoagulant should be considered for this high-risk group of Asian IBD inpatients.

Rational use of human albumin: plan-do-check-act cycle in clinical practice

ObjectiveImproper use of human albumin (HA) is now common in clinical settings. This study aims to explore the feasibility of the plan-do-check-act (PDCA) cycle in promoting the rational use of...

Nutritional Risk, Nutritional Status and Some Biochemical Parameters In Adult Burn Patients in Burn Intensive Care Unit: A Prospective Study

Nutritional therapy is very important in burn patients and plays a role in the prevention and treatment of malnutrition. Therefore, it is necessary to assess nutritional status, prevent or minimize nutritional problems, and monitor nutritional therapy. This study was conducted to determine the nutritional risk, nutritional status and biochemical parameters of adult burn patients in the burn intensive care unit. The 59 patients (women: 16, men: 43) between the ages of 19-64 were included in the study. Parameters such as NRS-2002 (admission and discharge), dietary intake, nutritional support status, serum albumin, and total protein (admission and discharge) were evaluated to determine the nutritional risk and nutritional status of the patients. In addition, body weight, mid-upper arm circumference, and triceps skinfold thickness were measured and body mass index was calculated (admission and discharge). The duration of hospitalization and burn percentage of men patients were higher than women (P

Is human albumin injection the best choice to treat hypoalbuminemia?

Currently, there is an irrational use of drugs in the treatment of hypoproteinemia. This study evaluates the value of 12 injections to provide a basis for drug selection for the treatment of hypoproteinemia. The content of the first restrictive amino acid, the comprehensive quality of the total essential amino acid, and the closeness to the whole egg protein or FAO/WHO model were evaluated to compare their value in the amino acid synthesis of human serum albumin. A comparison was made between the matching degree of HA and therapeutic amino acids with the human plasma amino acid profile. Furthermore, the value and safety of synthetic human serum albumin were compared. The lowest synthetic value of human serum albumin was 18AA-V, and the highest was 18AA-II. The CS values of HA, 18AA-V, 18AA-II, 18AA-Ip, 18AA-IIp, and 19AA-Ip were 0.18, 0.58, 0.78, 0.55, 0.54, and 0.59, respectively. The similarity to egg protein was 0.81, 0.92, 0.94, 1.00, 1.18, and 1.18, respectively. The proximity values to FAO/WHO standards were 0.81, 0.85, 0.90, 1.36, 1.54, and 1.54, respectively. The changes in 3AA and the amino acid profile were matched when liver function was abnormal. When the renal function was abnormal, 9AA was matched. During trauma, 18AA-VII was matched. The amino acid profile of HA did not correspond. Patients with normal liver and kidney function should choose compound balanced amino acid injection, while patients with abnormalities should choose 3AA. Patients with renal dysfunction should choose 9AA. Trauma patients should choose 18AA-VII.

Postoperative decrease in serum albumin as predictor of early acute periprosthetic infection after total knee arthroplasty

PurposePatients with hypoalbuminemia, (serum albumin (SA) < 3.5 g/dL) are at greater risk for complications after surgery, including increased postoperative infection rates after total knee arthroplasty (TKA). This study aimed to analyze both preoperative and postoperative SA in patients who experienced acute periprosthetic infection within the first 4 weeks after surgery.MethodsWe retrospectively analyzed data from 490 consecutive TKAs (314 patients). Five patients developed early acute infection requiring surgical treatment. SA data were collected preoperatively (SA0) and 1 week postoperatively (SA1W) to evaluate SA dynamics. Multiple patient and operative parameters that could influence SA were also analyzed.ResultsNo statistical differences were found in parameters expected to influence SA values between the surgically treated (STG) and non-treated groups (non-STG). None of the patients in STG had SA0 and SA1W below 3.5 g/dL. However, the amount and rate of SA reduction before and after surgery were significantly greater in STG than in non-STG.ConclusionSA dynamics revealed a greater reduction in both the amount and rate in STG before and after surgery than in non-STG. No correlation was found between early acute periprosthetic infection after TKA and each SA0 and SA1W time point. Further evaluation of the SA value of 3.5 g/dL as a threshold for acute early acute infection is warranted.

Evaluation of albumin and lactate dehydrogenase in comparison with cytokeratin 19 fragments and neuron‐specific enolase as diagnostic biomarkers for non‐small cell lung cancer

AbstractBackgroundThe diagnosis of non‐small cell lung cancer (NSCLC) is a clinical issue that requires attention, and more practical and effective biomarkers need to be selected to assist in diagnosis. This study aimed to examine the diagnostic value of serum albumin (ALB), lactate dehydrogenase (LDH), cytokeratin 19 fragments (CYFRA21‐1), and neuron‐specific enolase (NSE) for NSCLC.MethodsThe clinical data of 1048 NSCLC patients and 1125 healthy subjects were extracted from electronic medical records. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic significance of ALB, LDH, CYFRA21‐1, and NSE for NSCLC. The Cancer Genome Atlas (TCGA) data, which included mRNA profiles for ALB and LDH expression, were acquired from TCGA Program. Finally, interactive survival scatter plots and survival analyses for NSCLC patients were evaluated using the Human Protein Atlas and Kaplan–Meier Plotter.ResultsSignificant differences were noted in the levels of ALB and LDH between NSCLC patients and healthy controls. The areas under the ROC curves (AUCs) for ALB and LDH were 0.754 (95% CI: 0.734–0.774) and 0.681 (95% CI: 0.658–0.704), respectively. Moreover, the combination of ALB and LDH raised the AUC to 0.804 (95% CI: 0.785–0.823), and the incorporation of CYFRA21‐1 and NSE further increased the AUC to 0.903 (95% CI: 0.890–0.916). Notably, ALB and LDH might be related to the overall survival of NSCLC patients.ConclusionThis study revealed that ALB and LDH in NSCLC patient serum could improve the diagnostic accuracy of conventional biomarkers for NSCLC.

Serum albumin level is associated with mortality and hospital stays: A real-world data analysis

Background & AimsThe value of serum albumin might be underestimated, especially in cancer patients. We thus aimed to evaluate the association between serum albumin level at hospital admission and clinical outcomes in hospitalized patients with cancer. MethodsThis is a retrospective, cross-sectional, and real-world data analysis. Hospitalized adult patients with malignant cancer were recruited from two tertiary hospitals. Serum level of albumin, which was measured within 24 hours after hospital admission, was the exposure. Length of hospital stays (LOS) was the primary and all-cause in-hospital mortality was the secondary outcomes. Other information, including age, sex, types of cancer, history of hypertension and diabetes, surgery, blood routine test, liver and renal function, and dietary intake, were also abstracted from medical records. ResultsA total number of 5,187 adult patients with cancer (2,949 were men and 2,238 women; average age 61.6±12.4 years and average albumin 40.3±5.2 g/L) were included. The prevalence of hypoalbuminemia was 12.2% (634/5,187). Older patients, patients with liver injury, anemia, and with high level of WBC were positively, while those with overweight and high level of total triglycerides, were negatively associated with hypoalbuminemia. After adjustment of covariates, hypoalbuminemia was significantly associated with longer LOS in the current study. The increase of 5 g/L in serum level of albumin could result in 1.09 days (95%CI: -1.38, -0.80 days) shorter in LOS. The increase of 5 g/L in serum level of albumin was also associated with 45% lower in risk of mortality (OR=0.55; 95% CI: 0.43, 0.7) after fully adjustment. ConclusionsSerum albumin level at admission was associated with both LOS and mortality in patients with malignant cancer.

Calf circumference-albumin index significantly predicts the prognosis of older patients with cancer cachexia: A multicenter cohort study

ObjectivesThe aim of this study was to evaluate the combined prognostic value of calf circumference (CC) and serum albumin on mortality in patients with cancer cachexia aged ≥65 years. MethodsThis multicenter cohort study involved 5322 older patients in hospital with cancer cachexia. The combined indicator of CC and albumin was defined as the calf circumference-albumin (CCA) index. Harrell's C index, a time-dependent receiver operating characteristic curve analysis, was used to assess the prognostic performance of the CCA index and other indices. The optimal thresholds method was used to determine the cutoff values of CC and albumin, and the association between the CCA index and all-cause mortality was assessed using Kaplan-Meier analysis and Cox proportional hazard regression models. ResultsA total of 3875 men and 1447 women with a mean age of 72.0 years (range: 68.0–78.0 years) and a mean follow-up time of 55.0 months (range: 25.0–85.0 months) were included in the study. A total of 1269 patients were classified into the low CCA index group (0 score) by the optimal thresholds method. In the overall population, the CCA index showed better differentiating power at predicting mortality in older patients with cancer cachexia compared with CC or albumin alone (C index = 0.639; 95% CI: 0.612–0.666; P < 0.05). The time-dependent receiver operating characteristic curve showed that the CCA index had the highest prognostic value of all the measures studied (P < 0.05). In the overall population, male and female patients with a high CCA index (2 score) showed better performance than those with a low CCA index (0 or 1 score). ConclusionsThe CCA index could significantly predict the mortality of older patients with cancer cachexia, which might provide renewed assistance for future clinical management.

A Simple Frailty Index Predicts Inhospital Mortality

Introduction: Comparing frailty models in different settings that predict inhospital mortality might modify patient disposition and treatment, but models are often complex. Methods: In the following study, we selected all acutely admitted adult patients in 2020–2021 to the three internal medicine departments at a regional 400-bed hospital. We attempt to determine (a) if a new scale (Laniado-4 scale) that includes only three yes/no questions derived from the Norton scale and the presence of a urinary catheter performs as well as the graded Norton scale (including all five domains), in predicting inhospital mortality and (b) to determine the predictive value of a simple frailty index that includes the new scale as well as categories of age, serum albumin, and creatinine values. We calculated odds ratios with 95% confidence intervals and c-statistics for the various models predicting inhospital mortality. Results: The mean patient age was 73 ± 19 years, and 49.1% (5,665/11,542) were males. A Laniado-4 scale performed better than the Norton scale for predicting inhospital mortality. A simple frailty index ranging from 0 to ≥8 points was associated with rates of inhospital mortality that increased from 0 to 37.7%, with an odds ratio of 2.13 (2.03–2.25) per 1 index point. The c-statistic was 0.887 (0.881–0.893). Conclusions: We conclude the Laniado-4 scale performed better than the Norton scale in predicting inhospital mortality and that a simple frailty index that included the 4-question scale and categories of age, serum creatinine, and serum albumin performed as well or better than more complicated models.

The predictive value of albumin to alkaline phosphatase ratio for vertebral refractures in postmenopausal women.

To investigate the clinical value of serum albumin to alkaline phosphatase ratio (AAPR) in predicting the risk of osteoporotic vertebral refractures group (OVRFs) after percutaneous vertebral augmentation (PVA) in postmenopausal women. This is a retrospective case-control study including a series of postmenopausal women patients with osteoporotic vertebral fracture (OVF) and underwent PVA. Patients were divided into OVRFs and non-OVRFs. COX model was used to evaluate the correlation between preoperative AAPR and OVRFs after PVA. The receiver operating characteristic (ROC) curve and Kaplan-Meier method were used to analyze the predictive value of AAPR for the incidence of OVRFs. A total of 305 patients were included in the final study, and the incidence of postoperative OVRFs was 28.9%. Multivariate COX analysis showed that advanced age (HRs = 1.062, p = 0.002), low BMI (HRs = 0.923, p = 0.036), low AAPR (HRs = 0.019, p = 0.001), previous fall history (HRs = 3.503, p = 0.001), denosumab treatment (HRs = 0.409, p = 0.007), low L3 BMD (HRs = 0.977, p = 0.001) and low L3 paravertebral muscle density (PMD)value (HRs = 0.929, p = 0.001)) were closely related to the incidence of OVRFs. The area under the curve (AUC) of AAPR for predicting OVRFs was 0.740 (p < 0.001), and the optimal diagnostic cut-off value was 0.49. Kaplan-Meier curve analysis showed that low AAPR group (< 0.49) was significantly associated with lower OVRFs-free survival (p = 0.001; log-rank test). AAPR is an independent risk factor for OVRFs after PVA in postmenopausal women, and it can be used as an effective index to predict OVRFs.

Nutrition-associated markers and outcomes among patients receiving enteral nutrition after ischemic stroke: a retrospective cohort study

BackgroundEarly nutrition after acute ischemic stroke is crucial. We explored early enteral nutrition for stroke patients and evaluated changes in blood indicators as a predictor of stroke prognosis.MethodsAll hospitalized stroke patients receiving enteral nutrition were included in the study. We retrospectively collected the protein, energy, fat, and carbohydrate values for 7 days after admission. Serum albumin, total protein, and hemoglobin values were reviewed at admission and at one week. The main outcome indicators were the Modified Rankin Score, Barthel Index, and Quality of Life at 3 months.ResultsA total of 354 patients (mean age, 70.7 years; 59.0% male) were included. The change in serum albumin at day 7 relative to at admission was positively correlated with the Quality of Life score (p = 0.001), the Barthel Index (p = 0.004), and the modified Rankin Score (p = 0.029). The change in total protein at day 7 relative to at admission was positively correlated with the Quality of Life score (p = 0.002), the Barthel Index (p = 0.001), and the modified Rankin score (p = 0.011). The change in hemoglobin values at day 7 relative to at admission was positively correlated with the Barthel Index (p = 0.037 but not with the Quality of Life score (p = 0.237) or the modified Rankin score (p = 0.730).ConclusionsImproved nutrition-related blood indicators one week after admission were independently associated with good stroke outcomes. Nutritional support for acute ischemic stroke patients during the early hospitalization stage appears to be advisable.Trial registrationThis review was a retrospective cohort study. The study was retrospectively registered in the Chinese Clinical Trial Registry (No: ChiCTR2300077228). Registration date: 1/11/2023.

Feeding Tube Clinic Effect on Nutrition.

Optimizing nutrition is essential for recovery after major surgery or severe illness. Feeding tubes (FT) can be placed in patients limited by oral enteral nutrition. Given the myriad of locations in which these procedures are performed (radiology, intensive care unit, and endoscopy suite), routine follow-up is challenging. The purpose of this study was to evaluate the impact of an FT clinic on nutrition. We hypothesized that enrollment in the FT clinic would result in improved nutritional outcomes. Retrospective review of Veteran Affairs Medical Center patients with FTs placed from January 2010 to January 2020. Demographics and body mass index (BMI) were recorded. Serum albumin recorded within 1 month of tube placement was compared to within 1 month of tube removal, death, or at the end of the study period. FT clinic participation required at least 2 visits. Indications for FT placement and duration were recorded. Patients were excluded when both BMI and albumin values were incomplete, and if FTs were placed for decompression. Ninety-three patients underwent FT placement during the study period; 5 (5%) were excluded. The average age was 64.8±9.7 years, with the majority being male, 85 patients (97%). Eighteen (20%) patients were seen in the FT clinic (FTC) and 70 (80%) were managed outside of FTC (nFTC). There were no differences in age, gender, or indication for FT. Mean albumin increased 0.42±0.85g/dL in the FTC group versus -0.07±0.72g/dL in the nFTC group ( P =0.037). The FTC group BMI increased, 0.38kg/m 2 vs. -1.48kg/m 2 in nFTC patients, P =0.041. The FTC patients maintained their tubes longer (36.5 vs. 7.0mo, P =0.0014). Patients managed in a dedicated FT clinic experienced an improvement in their serum albumin values and increases in their BMI. In addition, they also maintained their FTs longer. To optimize nutrition and reduce weight loss, patients who require FTs should be enrolled in a dedicated FT clinic.

Relationship of C-reactive Protein/Serum Albumin Ratio and qPitt Bacteremia Score With An All-Cause In-Hospital Mortality in Patients With Bloodstream Infections.

Bloodstream infections remain a major cause of morbidity and mortality despite notable advances in their diagnosis and treatment. C-reactive protein/serum albumin ratio and the quick Pitt bacteremia score are two useful tools for clinicians to assess severity and predict mortality risk in patients with sepsis attributable to bloodstream infections. This study examined the relationship between C-reactive protein/serum albumin ratio and Q Pitt bacteremia score with all-cause in-hospital mortality in patients with bloodstream infections. Hospitalized adult patients with bacteremic bloodstream infections between January 1, 2020, and December 31, 2021, were retrospectively reviewed. Patients' demographics and clinical and laboratory data were retrieved from patient electronic records. C-reactive protein/albumin ratio was calculated using CRP (mg/L) and serum albumin (g/L) values obtained within 24 hours of blood culture collection and quick Pitt bacteremia score was calculated for each patient with each of the five variables of the score determined within 24 hours of blood culture collection and each patient was assigned a numerical score of 0-5 accordingly. The relationship between C-reactive protein/albumin ratio and quick Pitt bacteremia score with all-cause in-hospital mortality was determined. A total of 187 hospitalized adult patients with non-repeat bacteremic bloodstream infections were identified.Escherichia coliwas the most common Gram-negative blood isolate whileStaphylococcus aureuswas the predominant Gram-positive isolate. One hundred and five (56.1%) patients were male with a cohort mean age of 56.9 ± 2.7 years. All-cause in-hospital mortality was 27.3%. The mean CRP/albumin ratio (8.6 ±1.7) and mean quick Pitt bacteremia score (2.8 ±0.4) were significantly higher in patients with bloodstream infections who died during their hospitalization compared to those who survived. The all-cause in-hospital mortality was 8%, 12%, 22%, 46%, 93%, and 100% for patients with quick Pitt scores of 0, 1, 2, 3, 4, and 5, respectively. In hospitalized patients with bacteremic bloodstream infections, an incremental increase in quick Pitt bacteremia score and mean C-reactive protein/albumin ratio of >8 was associated with higher mortality.

Importance of serum albumin in machine learning-based prediction of cognitive function in the elderly using a basic blood test.

In this study, we investigated the correlation between serum albumin levels and cognitive function, and examined the impact of including serum albumin values in the input layer on the prediction accuracy when forecasting cognitive function using deep learning and other machine learning models. We analyzed the electronic health record data from Osaka Medical and Pharmaceutical University Hospital between 2014 and 2021. The study included patients who underwent cognitive function tests during this period; however, patients from whom blood test data was not obtained up to 30 days before the cognitive function tests and those with values due to measurement error in blood test results were excluded. The Mini-Mental State Examination (MMSE) was used as the cognitive function test, and albumin levels were examined as the explanatory variable. Furthermore, we estimated MMSE scores from blood test data using deep learning models (DLM), linear regression models, support vector machines (SVM), decision trees, random forests, extreme gradient boosting (XGBoost), and light gradient boosting machines (LightGBM). Out of 5,017 patients who underwent cognitive function tests, 3,663 patients from whom blood test data had not been obtained recently and two patients with values due to measurement error were excluded. The final study population included 1,352 patients, with 114 patients (8.4%) aged below 65 and 1,238 patients (91.6%) aged 65 and above. In patients aged 65 and above, the age and male sex showed significant associations with MMSE scores of less than 24, while albumin and potassium levels showed negative associations with MMSE scores of less than 24. Comparing MMSE estimation performance, in those aged below 65, the mean squared error (MSE) of DLM was improved with the inclusion of albumin. Similarly, the MSE improved when using SVM, random forest and XGBoost. In those aged 65 and above, the MSE improved in all models. Our study results indicated a positive correlation between serum albumin levels and cognitive function, suggesting a positive correlation between nutritional status and cognitive function in the elderly. Serum albumin levels were shown to be an important explanatory variable in the estimation of cognitive function for individuals aged 65 and above.

Evaluation of fecal calprotectin levels in neonatal calves with diarrhea

This study aimed to determine the levels of fecal calprotectin in calves that had diarrhea in the neonatal period. The study was carried out on a total of 52 calves, 42 with diarrhea (diarrhea group) brought to the Animal Hospital of the Faculty of Veterinary Medicine, Balikesir University, for diagnosis and treatment, and 10 healthy (control group). The diarrhea-afflicted calves ranged in age from 3 to 30 days and included a variety of races and sexes. For blood gases, hematological, and biochemical analyses, ten milliliters of blood were collected from each calf’s jugular vein. To determine the levels of calprotectin, stool samples were gathered and stored in sterile containers. The heart rate and capillary refill time (CRT) of the calves with diarrhea were significantly (P&lt;0.05) higher than the control group. The calves who had diarrhea also had increased potassium (K) and creatinine levels in addition to metabolic acidosis and hyponatremia. Furthermore, the serum albumin and oxygen saturation values of the diarrheal calves were found to be significantly lower than those of the control group. Fecal calprotectin levels were found to be significantly higher in the calves with diarrhea compared to the control group. When fecal calprotectin levels were examined in terms of etiological factors, no statistical difference was detected between the groups. Consequently, it was determined that fecal calprotectin levels in calves with diarrhea could be a potential biomarker for enteritis.

Hypocalcemia in the Immediate Postoperative Period Following Metabolic Bariatric Surgery - Hype or Harm?

Hypocalcemia post-metabolic bariatric surgery (MBS) is a known long-term complication after hypoabsorptive procedures. However, data on immediate postoperative calcium are limited. Our aim was to evaluate the prevalence of hypocalcemia on the 1st postoperative day after MBS and correlate it with potential associated factors. We analyzed data from all consecutive index MBS over 1 year. We collected data on demographics and on preoperative and postoperative values of serum calcium (TC), albumin, adjusted calcium (AC-Payne formula), magnesium, phosphorus, preoperative vitamin-D, and postoperative 24-h urine output, intravenous fluids (IVF), bolus intravenous furosemide, and creatine phosphokinase (CPK). Continuous data are expressed as means ± SD (range). Categorical data are presented as frequencies (%). Linear regression was implemented to designate potential correlations. The cohort included 86 patients (58.1% females). The mean preoperative TC was 9.4mg/dL ± 0.4 (8.5-10.5) and mean postoperative TC 7.8mg/dL ± 0.6 (6.3-9.3, 17.0% decrease). The mean preoperative AC was 10.1mg/dL ± 0.4 (9.2-11.2) and mean postoperative AC 8.5mg/dL ± 0.6 (7.0-10.0, 15.8% decrease). Seventy-three patients (84.8%) had abnormally low TC (< 8.5mg/dL), and 43 (50%) abnormally low AC. There was only weak correlation between postoperative TC and AC with magnesium (r = 0.258), phosphorus (r = 0.269), vitamin-D (-0.163), 24-h urine output (r = -0.168), IVF (r = -0.237), bolus furosemide (r = 0.155), and mean operative time (r = 0.010). In our cohort of patients, hypocalcemia was a real problem but we did not find any significant correlation with the examined factors. Further studies are warranted to validate our findings and investigate other potential correlations.

External validation of the lactate dehydrogenase/albumin ratio as a clinical predictor of overall survival in Peruvians with diffuse large B cell lymphoma.

e19072 Background: The lactate dehydrogenase/albumin ratio (RLA), a potentially promising inflammatory biomarker derived from the division of serum lactate dehydrogenase and albumin values, has shown a strong correlation with overall survival (OS) in patients with diffuse large B-cell lymphoma (DLBCL). However, its validity in our specific population requires confirmation. We aimed to validate the RLA as an early predictor of OS in a cohort of Peruvian patients with DLBCL. Methods: We conducted a retrospective cohort study recruiting consecutive patients diagnosed between 2009 and 2017, with the last follow-up on July 1, 2022, at the National Hospital Edgardo Rebagliati Martins and the Maria Auxiliadora Hospital. The optimal cutoff point for RLA was estimated using ROC curve analysis, and survival curves were plotted and analyzed using Cox regression and Kaplan-Meier methods with the Log-Rank test. Results: A total of 283 patients with a median follow-up of 2.6 (range: 0.02-10.51) years were included. The optimal cutoff point for RLA was established at 23.6. Values below 23.6 were associated with poor OS when comparing survival curves (p&lt;0.001). In the multivariate model, a prognostic association was found between RLA and OS (HR: 3.37, 95% CI: 1.78-6.39, p&lt;0.001). Conclusions: The RLA is confirmed as a valid biomarker in our population for predicting OS in patients with diffuse large B-cell lymphoma (DLBCL), allowing for early evaluation. [Table: see text]

#704 Albumin, inflammation and nutrition in hemodialisis patients in Colombia: a cohort study

Abstract Background and Aims Hypoalbuminemia is a well-identified risk factor for mortality in chronic hemodialysis patients. As a negative acute phase reactant, albumin levels could be associated with several factors that affect the patient on hemodialysis (HD), such as alterations in the rate of hepatic synthesis, an increase in the rate of catabolism, or an increase in losses due to the dialysis process. The objective of the present study is to analyze serum albumin values in repeated measurements over time in two cohorts, one with expanded HD (HDx) enabled by the medium cut-off membrane (MCO) Theranova and the other with high flux (HF) HD and estimate the relationship with other relevant variables. Method Cohort study, one with HDx enabled by Theranova® and the other with HF HD, adult prevalent HD patients (&amp;gt; 90 days) at Baxter Renal Care Services Colombia starting between September 1, 2017, and November 30, 2017, with follow-up for up to 48 months. Sociodemographic and clinical characteristics were summarized descriptively, and a mixed linear model with repeated measures was performed to evaluate the association between dialysis membrane and albumin levels, controlling for confounding variables. Results We evaluated 1092 patients (62% male): 533 in HF-HD vs. 559 in HDx (Table 1); the median age was 61 years, 42% had a history of diabetes, and 19% had cardiovascular disease. We found no differences in albumin levels over time when comparing Theranova versus HF HD patients, p-value = 0.789 (see Fig. 1). No association between serum albumin levels and the Theranova dialyzer was found with the linear mixed model with repeated measures when controlling for confounding variables, p-value= 0.198. On the other hand, we found that serum albumin was associated with inflammatory and nutritional variables such as C reactive protein, Ratio platelets/lymphocytes, and Protein Energy Wasting (PEW) (Table 2). Conclusion Variables including nutritional status and inflammation, age, and hospitalization events are associated with serum albumin levels varying over time. Variation in serum albumin levels over time are not associated with type of dialyzer (Theranova® vs HF).

Prognostic role of serum albumin levels in patients with chronic heart failure

BackgroundHypoalbuminemia is common in heart failure (HF) patients; however, there are no data regarding the possible long-term prognostic role of serum albumin (SA) in the younger population with chronic HF without malnutrition. The aim of this study was to examine the long-term prognostic role of SA levels in predicting major adverse cardiac events (MACE) in middle-aged outpatients with chronic HF.MethodsIn the present retrospective analysis, 378 subjects with HF were enrolled. MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, cardiac revascularization or coronary bypass surgery, and cardiovascular death), total mortality, and HF hospitalizations (hHF) occurrence were evaluated during a median follow-up of 6.1 years.ResultsIn all population, 152 patients had a SA value < 3.5 g/dL and 226 had a SA value ≥ 3.5 g/dL. In patients with SA ≥ 3.5 g/dL, the observed MACE were 2.1 events/100 patient-year; while in the group with a worse SA levels, there were 7.0 events/100 patient-year (p < 0.001). The multivariate analysis model confirmed that low levels of SA increase the risk of MACE by a factor of 3.1. In addition, the presence of ischemic heart disease, serum uric acid levels > 6.0 mg/dL, chronic kidney disease, and a 10-year age rise, increased the risk of MACE in study participants. Finally, patients with SA < 3.5 g/dl had a higher incidence of hHF (p < 0.001) and total mortality (p < 0.001) than patients with SA ≥ 3.5 g/dl.ConclusionsPatients with chronic HF that exhibits low SA levels show a higher risk of MACE, hHF and total mortality.