Giá trị tiên lượng tử vong của albumin huyết thanh ban đầu trong sốc nhiễm khuẩn ngoại khoa tại Bệnh viện Bạch Mai

Abstract

Hypoalbuminemia is common in critically ill patients, but data on its prognostic role in surgical septic shock in Vietnam remain limited. This study aimed to describe initial serum albumin levels, explore associated factors, and evaluate the prognostic value of albumin for 28-day mortality in comparison with commonly used prognostic indices (APACHE II, SOFA, lactate, and procalcitonin). A retrospective analytical study was conducted in 94 patients with septic shock of surgical origin who underwent surgery and were treated in the Department of Anesthesia and Critical Care, Bach Mai Hospital, from February to August 2020. Initial serum albumin was defined as the first serum albumin measurement obtained at ICU admission after surgery. Mean initial serum albumin was 22.7 ± 5.5 g/L. Albumin showed a weak positive correlation with body mass index and weak negative correlations with white blood cell count, lactate, and APACHE II score (p < 0.05). Twenty-eight-day mortality increased as albumin decreased (p = 0.015). Albumin showed fair prognostic performance, with an AUC of 0.724 (95% CI: 0.605 - 0.844) and an optimal cutoff of 20.75 g/L. In multivariable analysis, ASA > 3, APACHE II score, and initial serum albumin were independently associated with 28-day mortality. Initial serum albumin is a simple, readily available biomarker that may provide additional value for early risk stratification in patients with surgical septic shock.