1. Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage
- Author
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Floris H B M Schreuder, Mnemonich Investigators, Réza Behrouz, Christopher H. Topel, Jaime Masjuan Vallejo, Mario Di Napoli, Brian Silver, Hipólito Nzwalo, Paolo Pennati, Fulvio Pomero, Joshua Z. Willey, Julie Staals, Daniel Agustin Godoy, Vivek Misra, Catharina J.M. Klijn, Alessia Giraudo, Craig J. Smith, Luca Masotti, Mahmoud Reza Azarpazhooh, Aurel Popa-Wagner, Mark Slevin, Adrian R Parry-Jones, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), and RS: CARIM - R3.03 - Cerebral small vessel disease
- Subjects
Male ,Controlled trials ,Serum albumin ,RATIONALE ,Critical Care and Intensive Care Medicine ,GUIDELINES ,SERUM-ALBUMIN ,Cohort Studies ,0302 clinical medicine ,Modified Rankin Scale ,hemic and lymphatic diseases ,030212 general & internal medicine ,Hypoalbuminemia ,Hospital Mortality ,Registries ,Aged, 80 and over ,Hematoma ,biology ,Hypoalbuminemia/complications ,Ischemic stroke patients ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,ADMISSION ,humanities ,Patient Discharge ,Management ,CONTROLLED-TRIALS ,Quartile ,Italy ,Female ,CRITICALLY-ILL PATIENTS ,Cohort study ,Critically Ill patients ,Adult ,medicine.medical_specialty ,Critical Illness ,Stroke outcomes ,Admission ,Guidelines ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Internal medicine ,medicine ,MANAGEMENT ,Humans ,cardiovascular diseases ,Intensive care medicine ,HEMATOMA ,Serum Albumin ,METAANALYSIS ,Aged ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,Inflammation ,business.industry ,Albumin ,medicine.disease ,Cerebral Hemorrhage/complications ,Rationale ,nervous system diseases ,Systemic inflammatory response syndrome ,Critical Illness/mortality ,biology.protein ,Systemic Inflammatory Response Syndrome/complications ,business ,030217 neurology & neurosurgery ,Meta analysis ,ISCHEMIC-STROKE PATIENTS - Abstract
Purpose: Hypoalbuminemia and systemic inflammatory response syndrome (SIRS) are reported in critically-ill patients, but their relationship is unclear. We sought to determine the association of admission serum albumin and SIRS with outcomes in patients with intracerebral hemorrhage (ICH). Methods: We used a multicenter, multinational registry of ICH patients to select patients in whom SIRS parameters and serum albumin levels had been determined on admission. Hypoalbuminemia was defined as the lowest standardized quartile of albumin; SIRS according to standard criteria. Primary outcomes were modified Rankin Scale (mRS) at discharge and in-hospital mortality. Regression models were used to assess for the association of hypoalbuminemia and SIRS with discharge mRS and in-hospital mortality. Results: Of 761 ICH patients included in the registry 518 met inclusion criteria; 129 (25%) met SIRS criteria on admission. Hypoalbuminemia was more frequent in patients with SIRS (42% versus 19%; p < 0.001). SIRS was associated with worse outcomes (OR: 4.68, 95% CI, 2.52-8.76) and in-hospital all-cause mortality (OR: 2.18, 95% CI, 1.60-2.97), while hypoalbuminemia was not associated with all-cause mortality. Conclusions: In patients with ICH, hypoalbuminemia is strongly associated with SIRS. SIRS, but not hypoalbuminemia, predicts poor outcome at discharge. Recognizing and managing SIRS early may prevent death or disability in ICH patients. Center's institutional/departmental funds Dutch Heart Foundation [2012T077] Netherlands Organisation for Health Research and Development, ZonMw [015008048] NIHR Clinician Scientist Award
- Published
- 2017