The correlation analysis of serum albumin levels and prognosis in children with sepsis

Objective To explore the association between hypoalbuminemia and the severity and prognosis of sepsis in children.Methods Children diagnosed as sepsis in PICU in Hunan Provincial Children's Hospital from February to July 2010 were retrospectively collected.Clinical manifestation,laboratory examination index,related parameters of disease severity and prognosis were extracted.According to albumin levels within 24 h admission into PICU,the patients were divided into severe hypoalbuminemia group(≤25 g·L-1),moderate hypoalbuminemia group(-30 g·L-1),mild hypoalbuminemia group(-35 g·L-1) and normal albumin group( 35 g·L-1).The correlation of albumin levels with clinical manifestations,laboratory index and relevant outcome were analyzed.The relevance of albumin levels and the prognosis was analyzed by Logistic regression.Results A total of 212 cases meeting with sepsis criteria were analyzed,including 24 cases in severe hypoalbuminemia group,50 in moderate hypoalbuminemia group,61 in mild hypoalbuminemia group and 77 in normal albumin group.① The incidences of diarrhea,abdominal distension,bowel sound weakened,stress ulcer,edema and MODS 3 in severe hypoalbuminemia group were significantly elevated(P0.05).②With the serum albumin levels decreasing,the incidences of WBC count,CRP≥8 mg·L-1 and PCT2 mg·L-1,glucose ≥6.7 mmol·L-1 and lactate levels were increased(P0.05).③With the serum albumin levels decreasing,PRISM Ⅲ,the incidences of severe sepsis and septic shock were significantly elevated,while PICS was declined(P0.05).④Logistic regression analysis showed that PRISM Ⅲ≥8,severe sepsis and septic shock,severe hypoalbuminemia were death risk factors in children with sepsis,OR(95%CI) was 8.20(1.325-18.96),2.85(1.34-10.73)and 1.22(1.02-15.78) respectively.⑤The albumin levels in survival group 1,3 and 7 days after admission were significantly higher than the death or abandon group in the corresponding period,and there were significant differences.Conclusions Hypoalbuminemia can be used as an indirect inflammatory infection indicator to reflect the degree of severe infection.The albumin level≤25 g·L-1 can be used as the death risk factors in children with sepsis.