Human serum albumin usage in a comprehensive cancer center

During 1977, M.D. Anderson Hospital and Tumor Institute used 270,575 g of human serum albumin (HSA) at a patient cost of $1.1 million. For a 1-month period in early 1978, a survey of HSA usage was conducted in the 440-bed hospital. Patients who were started on albumin during the study period were included and monitored for the duration of their therapy. The largest groups of patients receiving albumin were those with gynecological tumors (30%) and gastrointestinal tumors (16%). Two-thirds of all patients receiving HSA were also receiving intravenous hyperalimentation (IVH); 80% of all HSA used was given to IVH patients. Although the IVH patients received a smaller daily dose of HSA, the average length of their therapy was about three times longer than that of the non-IVH patients. The mean total dose for the IVH patients was 344 g as compared to 180 g for non-IVH patients. For all patients, the mean total dose of HSA was 289 g at a patient cost of $1212. Of the patients, 66% had an initial serum albumin level determined before therapy was begun, 43% had a serum albumin level run at the termination of therapy, 16% had neither, and 28% had only one serum albumin level during their HSA therapy. Ninety percent of the patients had at least one period of 4 days or longer without a serum albumin level being obtained.