Evaluating albumin usage in an urban acute care hospital

At Cabrini Medical Center, a 499-bed acute care hospital in New York City, a concurrent review of 25% albumin usage was performed. A nationwide shortage, and a 40% increase in usage over the same time period the previous year, provided the justification for the study. Twenty-five percent albumin usage was monitored for a 2-month period. Patient characteristics, as well as information including type of medical service, number of units of albumin administered, dose, total serum protein, serum albumin, and patient outcome were recorded. A study population of 54 patients was identified. Of the 770 units of 25% albumin administered, 668 (87%) were deemed inappropriate, with the medical service responsible for 614 units, and the surgical service 54 units. This represented 92% and 8% of inappropriate use, respectively. Overall, 86% of albumin usage was by the medical service. This is in sharp contrast to the results obtained by previous investigators.