Clinical Value of Early Serum Albumin in Predicting Mortality Among Patients With Acute Pancreatitis: A Meta-Analysis

Acute pancreatitis (AP) is a critical illness that carries a considerable risk of severe complications and mortality. Serum albumin has been suggested as a marker of severity and worse outcomes in various critical illnesses. Accordingly, this meta-analysis was done to determine the clinical value of serum albumin in predicting mortality in patients with AP. A systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed in PubMed, Scopus, and the WHO Virtual Health Library (VHL) to retrieve relevant studies assessing the association between serum albumin and mortality in patients with AP. Statistical analyses were done by calculating the pooled standardized mean difference (SMD) and area under the curve (AUC) estimates with 95% CI, using the meta package of R version 4.4.3 (R Foundation for Statistical Computing, Vienna, Austria). A total of 16 studies, including 8,394 patients, were included in the meta-analysis. The results indicated that non-survivors had significantly lower serum albumin levels than survivors (SMD = -0.79; 95% CI -1.11 to -0.47; p < 0.0001). Prognostic accuracy analysis demonstrated moderate discriminatory ability for serum albumin (AUC = 0.75; 95% CI 0.67 to 0.82; p < 0.001). This meta-analysis demonstrates that hypoalbuminemia is an important biomarker for identifying patients with AP who are at increased risk of mortality.