Abstract 4145845: The Impacts of Albumin Levels on Clinical Outcomes in Patients in the Coronary Care Unit

Background: Hypoalbuminemia is frequently observed in critically ill patients, yet its significance regarding short-term mortality among these patients remains uncertain. We aimed to investigate the impact of albumin levels and their changes on clinical outcomes among patients who were admitted to intensive care units due to cardiac causes. Methods: This is a retrospective, single-center, cohort study. Consecutive patients admitted to coronary care unit (CCU) were enrolled between January 2011 and December 2020. Serum albumin levels were obtained upon CCU admission and tracked for changes. Clinical outcomes were defined as 30-day mortality. Results: A total of 4,004 patients were enrolled. Among them, 1,129 (28.2%) had acute coronary syndrome, 1,915 (47.8%) had coronary artery disease, 1,039 (25.9%) had arrhythmia, and 1,825 (45.6%) had heart failure. There were 643 deaths and 3,361 survivors within 30 days. When comparing to survivors, those who died within 30 days had lower initial albumin levels (3.2 ± 0.9 vs. 3.4 ± 0.8, P < 0.001) and albumin level reduction (-0.1 ± 0.9 vs. 0.0 ± 0.9, P = 0.005). Cox regression multivariate analysis indicated that higher initial albumin levels (HR, 0.638; 95% CI, 0.538 – 0.756, P < 0.001) and increase in albumin levels (HR, 0.638; 95% CI, 0.541 – 0.752, P < 0.001) were independently associated with lower 30-day mortality rates. Conclusions: Higher initial albumin levels and increase in albumin levels were linked to better clinical outcomes in patients admitted to CCU.