U-shaped association between serum albumin and pediatric intensive care unit mortality in critically ill children

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Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

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Xuepeng Zhang1,2,3, Lifan Zhang4, Canzheng Wei2,5

  • 1Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China.

Frontiers in Nutrition
|September 16, 2022
PubMed

Insights

Critically ill children show a U-shaped association between serum albumin levels and mortality risk. Lower and higher albumin levels are linked to increased mortality in pediatric intensive care units (PICUs).

Area of Science:

  • Pediatric critical care medicine
  • Clinical biochemistry
  • Epidemiology

Background:

  • The relationship between serum albumin levels and mortality in critically ill children remains under-investigated.
  • Understanding this association is crucial for improving outcomes in pediatric intensive care units (PICUs).

Purpose of the Study:

  • To investigate the detailed association between serum albumin levels and mortality in critically ill children.
  • To identify specific albumin thresholds associated with increased mortality risk.

Main Methods:

  • Retrospective data collection from 9,123 children across four Chinese PICUs (January 2015 - October 2020).
  • Utilized restricted cubic spline curves and logistic regression to analyze the association between serum albumin and PICU mortality.
  • Performed threshold effect analysis using piecewise regression models.

Main Results:

  • Overall PICU mortality was 5.3%.
  • A U-shaped association was observed between serum albumin levels and mortality risk.
  • Mortality risk decreased with rising albumin levels below 43.2 g/L (OR=0.919) but increased above this threshold (OR=1.174).

Conclusions:

  • A significant U-shaped association exists between serum albumin levels and mortality in critically ill children.
  • Both low and high serum albumin levels are independently associated with increased mortality risk in the PICU setting.
Abstract

Keywords:
albuminchildrencritical caremortalityrestricted cubic spline

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