THE PROGNOSTIC VALUE OF SERIAL MEASUREMENTS OF SERUM-ALBUMIN CONCENTRATION IN PATIENTS ADMITTED TO AN INTENSIVE-CARE UNIT

The prognostic value of serial measurements of serum albumin concentra tion during the first 72 h after admission to a general adult intensiv e care unit was retrospectively reviewed in 348 consecutive critically ill patients over a year period. The accuracy of the admission APACHE II (Acute Physiology And Chronic Health Evaluation) score in correctl y predicting patient outcome was compared with the serum albumin conce ntration measured at different times after intensive care unit admissi on. Multiple logistical regression analyses were performed to evaluate whether combining APACHE II and serum albumin into a unified risk ind ex improved prognostic accuracy. Serum albumin concentration on admiss ion was lower in non-survivors than in survivors and decreased more ra pidly in non-survivors (p < 0.001). The admission serum albumin concen tration was found to be an insensitive prognostic indicator. However, serum albumin measured after 24 h was as accurate as the admission APA CHE II score in correctly classifying patients according to outcome. T here was a good correlation between the admission APACHE II score and serum albumin measured after 24 h but not between the admission APACHE II and the admission serum albumin. Combining the APACHE II score and serial albumin concentrations into a unified risk of death equation d id not improve the accuracy of outcome prediction.