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Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage

2017-10Journal article Restricted access
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dc.contributor.authorDi Napoli, Mario
dc.contributor.authorBehrouz, Reza
dc.contributor.authorTopel, Christopher H.
dc.contributor.authorMisra, Vivek
dc.contributor.authorPomero, Fulvio
dc.contributor.authorGiraudo, Alessia
dc.contributor.authorPennati, Paolo
dc.contributor.authorMasotti, Luca
dc.contributor.authorSchreuder, Floris H. B. M.
dc.contributor.authorStaals, Julie
dc.contributor.authorKlijn, Catharina J. M.
dc.contributor.authorSmith, Craig J.
dc.contributor.authorParry-Jones, Adrian R.
dc.contributor.authorSlevin, Mark A.
dc.contributor.authorSilver, Brian
dc.contributor.authorWilley, Joshua Z.
dc.contributor.authorAzarpazhooh, Mahmoud R.
dc.contributor.authorVallejo, Jaime Masjuan
dc.contributor.authorNzwalo, Hipólito
dc.contributor.authorPopa-Wagner, Aurel
dc.contributor.authorGodoy, Daniel A.
dc.date.accessioned2019-11-20T15:07:18Z
dc.date.available2019-11-20T15:07:18Z
dc.date.issued2017-10
dc.description.abstractPurpose: Hypoalbuminemia and systemic inflammatory response syndrome (SIRS) are reported in critically-ill patients, but their relationship is unclear. We sought to determine the association of admission serum albumin and SIRS with outcomes in patients with intracerebral hemorrhage (ICH). Methods: We used a multicenter, multinational registry of ICH patients to select patients in whom SIRS parameters and serum albumin levels had been determined on admission. Hypoalbuminemia was defined as the lowest standardized quartile of albumin; SIRS according to standard criteria. Primary outcomes were modified Rankin Scale (mRS) at discharge and in-hospital mortality. Regression models were used to assess for the association of hypoalbuminemia and SIRS with discharge mRS and in-hospital mortality. Results: Of 761 ICH patients included in the registry 518 met inclusion criteria; 129 (25%) met SIRS criteria on admission. Hypoalbuminemia was more frequent in patients with SIRS (42% versus 19%; p < 0.001). SIRS was associated with worse outcomes (OR: 4.68, 95% CI, 2.52-8.76) and in-hospital all-cause mortality (OR: 2.18, 95% CI, 1.60-2.97), while hypoalbuminemia was not associated with all-cause mortality. Conclusions: In patients with ICH, hypoalbuminemia is strongly associated with SIRS. SIRS, but not hypoalbuminemia, predicts poor outcome at discharge. Recognizing and managing SIRS early may prevent death or disability in ICH patients.
dc.description.sponsorshipCenter's institutional/departmental funds
dc.description.sponsorshipDutch Heart Foundation [2012T077]
dc.description.sponsorshipNetherlands Organisation for Health Research and Development, ZonMw [015008048]
dc.description.sponsorshipNIHR Clinician Scientist Award
dc.identifier.doi10.1016/j.jcrc.2017.06.002
dc.identifier.issn0883-9441
dc.identifier.urihttp://hdl.handle.net/10400.1/12968
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.subjectIschemic stroke patients
dc.subjectCritically Ill patients
dc.subjectSerum albumin
dc.subjectControlled trials
dc.subjectManagement
dc.subjectMeta analysis
dc.subjectGuidelines
dc.subjectRationale
dc.subjectAdmission
dc.subjectHematoma
dc.subjectIntracerebral hemorrhage
dc.subjectAlbumin
dc.subjectHypoalbuminemia
dc.subjectInflammation
dc.subjectSystemic inflammatory response syndrome
dc.subjectStroke outcomes
dc.titleHypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage253
oaire.citation.startPage247
oaire.citation.titleJournal of Critical Care
oaire.citation.volume41
person.familyNameNzwalo
person.givenNameHipólito
person.identifier337064
person.identifier.ciencia-id2C1F-E4F3-2C79
person.identifier.orcid0000-0002-1502-3534
person.identifier.ridAAG-3931-2020
person.identifier.scopus-author-id36057285600
rcaap.rightsrestrictedAccess
rcaap.typearticle
relation.isAuthorOfPublication287f7d4e-5ad8-4794-b526-c61d32c00446
relation.isAuthorOfPublication.latestForDiscovery287f7d4e-5ad8-4794-b526-c61d32c00446

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