南方医科大学学报2025，Vol.45Issue(5)：1074-1081,8.DOI:10.12122/j.issn.1673-4254.2025.05.21
合并急性肾损伤的危重症患者输注白蛋白后血清白蛋白水平与28d死亡率的相关性
Association between serum albumin levels after albumin infusion and 28-day mortality in critically ill patients with acute kidney injury
摘要
Abstract
Objective To investigate the association of serum albumin level after human albumin infusion with 28-day mortality in critically ill patients with acute kidney injury(AKI)and its impact on 90-day outcomes of the patients.Methods We conducted a retrospective cohort study based on the MIMIC IV database(2008-2019),including 5918 AKI patients treated with albumin in the ICU.Based on serum albumin levels within 72 h after albumin infusion,the patients were divided into low(<30 g/L),medium(30-35 g/L),and high albumin(>35 g/L)groups.Restricted cubic spline regression and multivariate logistic regression were used to analyze the association of albumin levels with patient mortality,and the results were verified in a external validation cohort consisting of 110 sepsis-induced AKI patients treated in Nanfang Hospital between 2017 and 2022 using survival analysis and multivariate adjustment.Results In the MIMIC training cohort,multivariate logistic regression showed no significant differences in 28-day mortality of the patients with different albumin levels(P>0.05).However,restricted cubic spline analysis indicated a non-linear dose-response relationship between albumin levels and 28-day mortality(threshold effect:risk increased when albumin levels>3.6 g/dL).Secondary endpoint analysis revealed that the patients with high albumin levels had a shorter duration of mechanical ventilation(P<0.001)but a longer ICU stay(P<0.001).In the validation cohort,albumin levels≥30 g/L were significantly associated with a reduced 28-day mortality rate(P<0.05).Conclusion The association between increased serum albumin levels following albumin infusion and 28-day mortality of critically ill patients with AKI exhibits a cohort dependency and can be influenced by multiple factors including disease type and severity,infusion strategies,and statistical methods.关键词
急性肾损伤/危重症患者/白蛋白输注/血清白蛋白水平/28d死亡率Key words
acute kidney injury/critically ill patients/albumin infusion/serum albumin level/28-day mortality引用本文复制引用
张柳攀,石晓彤,李露兰,师瑞,安胜利,曾振华..合并急性肾损伤的危重症患者输注白蛋白后血清白蛋白水平与28d死亡率的相关性[J].南方医科大学学报,2025,45(5):1074-1081,8.基金项目
国家自然科学基金(82172175)Supported by National Natural Science Foundation of China(82172175). （82172175）
