Albuminemia as a Potential Predictor of Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI).
Level 3 - non-randomized controlled study
Retrospective observational cohort study evaluating prognostic association
PubMed 41226896 · doi:10.3390/jcm14217499
What was done
A single-center retrospective cohort study analyzed 925 patients with severe traumatic brain injury (TBI) admitted between January 1, 2020, and December 31, 2023. Serum albumin levels were tracked across five timepoints: hospital admission, ICU admission, ICU discharge, hospital discharge, and death. Patients were categorized into five albumin strata ranging from extreme hypoalbuminemia (<2.5 g/dL) to extreme hyperalbuminemia (≥5.5 g/dL). Primary endpoints assessed were in-hospital mortality, hospital length of stay, ICU length of stay, and duration of mechanical ventilation.
What was found
At hospital admission, 65.0% of patients had normal albumin (3.5–4.7 g/dL), 25.2% had hypoalbuminemia (<3.5 g/dL), and 9.4% had hyperalbuminemia (>4.7 g/dL). By ICU discharge, values shifted upward to extreme hyperalbuminemia in 62.6%, hyperalbuminemia in 15.8%, normoalbuminemia in 20.4%, and hypoalbuminemia in ≤1.3%. Overall in-hospital mortality was 12.7% (117/925) and did not differ significantly by albumin category at admission or discharge (χ² = 3.47, p = 0.32). Median hospital length of stay (5 days, IQR ≈ 11 days), ICU length of stay (1.3 days), and ventilator duration (0 days) showed no significant differences across albumin strata (all Kruskal-Wallis p > 0.10).
Why it matters
In contemporary neuro-intensive care settings where protein and fluid deficits are routinely corrected, dynamic serum albumin levels do not independently predict mortality or length of stay in severe TBI, suggesting albumin serves as a target of acute resuscitation rather than an autonomous prognostic marker.
Limits
The study is retrospective and conducted at a single center, limiting generalizability. The abstract does not detail specific resuscitation fluid protocols, exogenous albumin administration, or long-term functional neurological outcomes (such as Glasgow Outcome Scale scores) post-discharge.
Cited by
- contradicts Elevated serum albumin levels (hyperalbuminemia) are almost exclusively caused by acute dehydration and hemoconcentration.