Hypoalbuminemia in the outcome of patients with non-variceal upper gastrointestinal bleeding

• Published in: Revista de gastroenterología de México Vol. 81; no. 4; pp. 183 - 189
• Main Authors: González-González, J A, Vázquez-Elizondo, G, Monreal-Robles, R, García-Compean, D, Borjas-Almaguer, O D, Hernández-Velázquez, B, Maldonado-Garza, H J
• Format: Journal Article
• Language: English; Spanish
• Published: Mexico 01-10-2016
• Subjects: Adult; Aged; Aged, 80 and over; Female; Gastrointestinal Hemorrhage - complications; Gastrointestinal Hemorrhage - mortality; Gastrointestinal Hemorrhage - therapy; Hospital Mortality; Humans; Hypoalbuminemia - etiology; Male; Mexico - epidemiology; Middle Aged; Prospective Studies; Risk Factors; ROC Curve; Serum Albumin - analysis; Hypoalbuminemia; Rockall score; Gastrointestinal bleeding; Escala Rockall; Mortality; Mortalidad; Sangrado gastrointestinal; Hipoalbuminemia; Scoring systems; Sistemas de puntuación
• ISSN: 0375-0906
• DOI: 10.1016/j.rgmx.2016.03.005

The role of serum albumin level in patients with non-variceal upper gastrointestinal bleeding (NVUGB) has not been extensively studied. Our aim was to evaluate the role of serum albumin on admission in terms of in-hospital mortality in patients with NVUGB.
Patients admitted with NVUGB during a 4-year period were prospectively included. Demographic, clinical, and laboratory data were collected. ROC curve analysis was used to determine the cutoff value for serum albumin on admission that made a distinction between deceased patients and survivors with respect to serum albumin on admission, as well as its overall performance compared with the Rockall score.
185 patients with NVUGB were evaluated. Men predominated (56.7%) and a mean age of 59.1±19.9 years was found. Mean serum albumin on admission was 2.9±0.9g/dl with hypoalbuminemia (< 3.5g/dl) detected on admission in 71.4% of cases. The ROC curve found that the best value for predicting hospital mortality was an albumin level of 3.1g/dl (AUROC 0.738). Mortality in patients with albumin ≥ 3.2g/dl was 1.2% compared with 11.2% in patients with albumin<3.2g/dl (P=.009; OR 9.7, 95%CI 1.2-76.5). There was no difference in overall performance between the albumin level (AUORC 0.738) and the Rockall score (AUROC 0.715) for identifying mortality.
Patients with hypoalbuminemia presenting with NVUGB have a greater in-hospital mortality rate. The serum albumin level and the Rockall score perform equally in regard to identifying the mortality rate.