Hypoalbuminemia predicts clinical outcome in patients with type B acute aortic dissection after endovascular therapy

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• 作者：Rui Zeng ; PhD ; MD^a ; ¹ ; Dongze Li ; MBBS^b ; ¹ ; Lixia Deng ; MD^a ; Yarong He ; MD^b ; Xiaolin Sun ; PhD^a ; Zhi Wan ; PhD ; MD^b ; Hu Nie ; PhD ; MD^b ; Xiaodong Du ; PhD ; MD^b ; ^{dxd1204@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Yu Cao ; PhD ; MD^b ; ^{yuyuer@126.com" class="auth_mail" title="E-mail the corresponding author} ; Zhi Zeng ; MD^a ; ^b
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：34
• 期：8
• 页码：1369-1372
• 全文大小：298 K

文摘

Few studies have reported that serum albumin (SA) levels on admission were associated with increased risk of long-term outcomes in patients with type B acute aortic dissection (AAD). The aim of this study was to investigate the effect of admission levels of SA on survival among patients with type B AAD undergoing endovascular therapy (EVT).

Methods

A total of 131 patients with type B AAD undergoing EVT were retrospectively enrolled and followed up for 2.1 years. They were divided into hypoalbuminemia and nonhypoalbuminemia groups. We analyzed the incidence of inhospital complications and long-term mortality. Kaplan-Meier curves and multivariable Cox regression analyses were used to investigate the associations between SA levels and survival.

Results

Among 131 type B AAD patients, hypoalbuminemia was detected in 61 (46.6%) at admission. Compared to those without hypoalbuminemia, patients with hypoalbuminemia did not have higher inhospital complications; however, Kaplan-Meier analysis showed that they did have a significantly lower survival rate (73.8% vs 92.5%; log-rank χ² = 9.8; P = .002). Multivariable Cox regression analysis further revealed that hypoalbuminemia was an independent predictor of long-term mortality among patients with type B AAD (hazard ratio, 4.28; 95% confidence interval, 1.36-13.47; P = .013), over 2.1 years.

Conclusions

Hypoalbuminemia is common in type B AAD patients and is independently associated with increased risk of long-term death. Renal dysfunction may be the main pathophysiological mechanism underlying hypoalbuminemia in patients with type B AAD.