Acute and Critical Care

Original Articles

Infection
Early prognostication of septic shock in Korean adults aged 80 years and over: serum albumin combined with Sequential Organ Failure Assessment score: Sang-Min Kim, Seung Mok Ryoo, Woon Yong Kwon, Kyuseok Kim, Tae Ho Lim, Sung Pil Chung, Sung-Hyuk Choi, Won Young Kim; Acute Crit Care. 2026;41(2):304-314. Published online May 11, 2026; DOI: https://doi.org/10.4266/acc.005625

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Abstract PDF Supplementary Material: Background
Septic shock requires careful risk stratification in patients aged 80 and over. Serum albumin levels reflect host status and, when combined with the severity of organ dysfunction, may enhance early prognostication. Here, we evaluated whether combining albumin levels with the Sequential Organ Failure Assessment (SOFA) score upon emergency department (ED) arrival can improve risk classification. Methods: We conducted an observational study from October 2015 to May 2022 using a prospective multicenter registry of septic shock from 12 EDs in the Korean Shock Society. We included 1,300 (18.8%) patients with septic shock aged ≥80 years. The SOFA score was calculated in the ED at the time of septic shock recognition. Patients were divided into three groups according to albumin levels (cutoff, 3.5 g/dl) and the initial SOFA score (cutoff, 7): A, normal albumin with low SOFA score; B, high SOFA with normal albumin or low SOFA with low albumin; and C, low albumin with high SOFA score. The primary outcome was 28-day mortality. Results: Groups A, B, and C included 175, 592, and 533 patients, with 28-day mortality rates of 12.0%, 26.9%, and 49.3%, respectively. Adjusted odds ratios (95% CI) for mortality were 3.02 (1.76–5.18) for group B and 5.80 (3.38–9.97) for group C vs. group A. Conclusions: Combining the SOFA score with the albumin level allows early classification of patients aged ≥80 years with septic shock in the ED, facilitating treatment discussions, particularly decision-making with patients and their families.

Infection
Neutrophil-to-lymphocyte-to-albumin ratio as a prognostic marker for mortality in sepsis and septic shock in Vietnam: Nguyen Van Viet Thang, Le Thi Luyen, Nguyen Thi Tuong Vi, Pham Dang Hai; Acute Crit Care. 2025;40(2):244-251. Published online May 28, 2025; DOI: https://doi.org/10.4266/acc.003576

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Background
Sepsis and septic shock are life-threatening global health challenges associated with high mortality rates. Early identification of high-risk patients is critical for improving outcomes. In the present study, the association between the neutrophil-to-lymphocyte-to-albumin ratio (NLAR) and mortality in septic patients was evaluated.
Methods
A retrospective study was performed at a tertiary hospital in Vietnam. Patients ≥18 years of age diagnosed with sepsis or septic shock based on the Sepsis-3 criteria were included. Exclusion criteria included recent corticosteroid use within 7 days, autoimmune diseases, hematological disorders, and active cancer within 5 years. NLAR was calculated from complete blood counts and albumin levels within the first 24 hours of intensive care unit admission. Receiver operating characteristic (ROC) curves were used to determine the predictive ability of NLAR for in-hospital mortality.
Results
The present study included 141 patients with a mean age of 72 years. Non-survivors were significantly older with higher rates of mechanical ventilation. NLAR was significantly elevated in non-survivors compared with survivors (0.88 [0.57–1.24] vs. 0.44 [0.28–0.77], P<0.001). In ROC analysis, the area under the curve for NLAR was 0.70 (P<0.001). Using a cutoff value of 0.56, NLAR showed a sensitivity of 77.8% and a specificity of 61.5% for predicting in-hospital mortality.
Conclusions
Elevated NLAR on admission was associated with a higher mortality rate in sepsis patients. NLAR could be used as an early prognostic marker for sepsis mortality.

Citations

Citations to this article as recorded by

Vitamin B1 and sepsis: a prospective single-center study
Wenbo Yan, Yushu Ma, Jingping Yang, Hongyan Wang, Tiewei Li
Frontiers in Nutrition.2026;[Epub] CrossRef
Altered albumin/neutrophil to lymphocyte ratio are associated with all-cause and cardiovascular mortality for advanced cardiovascular-kidney-metabolic syndrome
Xiaoshuang Yin, Jinmei Zou, Jing Yang
Frontiers in Nutrition.2025;[Epub] CrossRef
The Neutrophil-to-Albumin Ratio (NAR) Reflects the Severity of the Post-CABG Inflammatory Response and Is Associated with a Pre-Existing Pro-Inflammatory Monocyte Profile
Mikhail A. Popov, Siarhei A. Dabravolski, Vladislav V. Dontsov, Sergei A. Vzvarov, Evgeniy G. Agafonov, Dmitriy I. Zybin, Alexandra K. Kharabet, Olga V. Radchenkova, Dmitriy R. Saveliev, Victoria P. Pronina, Svetlana S. Verkhova, Nikita G. Nikiforov, Yego
Life.2025; 15(12): 1790. CrossRef
Neutrophil Extracellular Traps in Sepsis and Sepsis-Related Organ Dysfunction
Wenbo Yan, Xiyuan Xu, Xiaojuan Li, Yushu Ma, Lining Guo, Jingping Yang, Zhipeng Jin, Jie Zhang, Tiewei Li
ImmunoTargets and Therapy.2025; Volume 14: 1373. CrossRef
Diagnostic utility of serum prostate-specific antigen and circulating inflammatory markers for differentiating prostate cancer from benign prostatic hyperplasia
Dawei Luo
American Journal of Cancer Research.2025; 15(11): 4765. CrossRef

Surgery
Biomarkers to predict mortality in patients with Fournier’s gangrene admitted to the intensive care unit after surgery in South Korea: In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim; Acute Crit Care. 2023;38(4):452-459. Published online November 21, 2023; DOI: https://doi.org/10.4266/acc.2023.00766

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Background
The use of biomarkers to predict patient outcomes may be crucial for patients admitted to the intensive care unit (ICU) following surgery because biomarkers guide clinicians in tailoring treatment plans accordingly. Therefore, we aimed to identify potential biomarkers to predict the prognosis of patients with Fournier’s gangrene (FG) admitted to the ICU after surgery.
Methods
We enrolled patients with FG admitted to our Hospital between January 2013 and December 2022. We retrospectively analyzed patient characteristics, factors related to management, scores known to be associated with the prognosis of FG, and laboratory data.
Results
The study population included 28 survivors and 13 nonsurvivors. The initial serum lactate level taken in the emergency department; white blood cell, neutrophil, and platelet counts; delta neutrophil index and international normalized ratio; albumin, glucose, HCO3, and postoperative lactate levels; and the laboratory risk indicator for necrotizing fasciitis differed between survivors and nonsurvivors. Postoperative lactate and initial albumin levels were independent predictors of mortality in patients with FG. In the receiver operating characteristic curve analysis, the postoperative lactate level was the best indicator of mortality (area under the curve, 0.877; 95% confidence interval, 0.711–1.000). The optimal cutoff postoperative lactate level for predicting mortality was 3.0 mmol/L (sensitivity, 80.0%; specificity, 95.0%).
Conclusions
Postoperative lactate and initial albumin levels could be potential predictors of mortality in patients with FG admitted to the ICU after surgery, and the optimal cutoff postoperative lactate and initial albumin levels to predict mortality were 3.0 mmol/L and 3.05 g/dl, respectively. Large-scale multicenter prospective studies are required to confirm our results.

Citations

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Revolutionizing Gangrene Therapy: Nanoparticle-Based Interventions and Biomarker Applications
Elizabeth Rani Edwin, Silpa Jayaprakash, Yamuna Gopi, Praveen Madhaiyan, Punniyakoti V. Thanikachalam, Pavithra Bharathy
Biomedical Materials & Devices.2026; 4(2): 1572. CrossRef
Diagnostic Accuracy of Red Cell Distribution Width-Derived Indices for Predicting In-Hospital Mortality in Scrotal Fournier’s Gangrene: A Retrospective Cohort Study
Rıdvan Kayar, Kemal Kayar, İlker Artuk, Samet Demir, Emre Tokuc, Metin Öztürk
Surgical Infections.2026; 27(3): 201. CrossRef
Risk Factors for Mortality in Patients With Necrotizing Fasciitis: A Systematic Review and Meta‐Analysis
Rui Zhang, Zheng Xu, Qi Han, Guosheng Wang, Srijoni Sengupta
International Journal of Clinical Practice.2026;[Epub] CrossRef
Successful Surgical Management of Fournier’s Gangrene: A Case Report
Nurzhan Isabekov, Karakoz Amantayeva, Gulbarshyn Eskali
Australian Journal of Biomedical Research.2026; 2(2): aubm019. CrossRef
A Retrospective Evaluation of Cases of Necrotizing Fasciitis Presenting to the Emergency Department
Gürkan Altuntaş, Mümin Murat Yazıcı, İsmail Ataş, Meryem Kaçan, Özlem Bilir
Hamidiye Medical Journal.2025; 6(2): 78. CrossRef
Integrative Management Strategies for Improved Outcomes in Fournier’s Gangrene: A Case Series Analysis from India
Awadhesh Kumar Pandey, Nasrin Habeeb, Aadithyaraj Kunnummal Thilakan, Rahul Sherkhane, Arun Kumar Dwivedi
Journal of Wound Management and Research.2025; 21(3): 148. CrossRef
Predictive value of elevated interleukin-33 levels for multi-organ dysfunction syndrome in trauma patients in South Korea: a prospective observational study
Sanghyun An, In Sik Shin, Myoung Jun Kim, Da Kyung Kim, Md Habibur Rahman, Cheol-Su Kim, Kwangmin Kim
Acute and Critical Care.2025; 40(4): 594. CrossRef
Predictors of in-hospital mortality in Fournier gangrene at four Korean tertiary hospitals: a multicenter retrospective cohort study
In Sik Shin, Sung Woo Jang, Chan Hee Park, Jeong Woo Lee, Hui-Jae Bang, Kwangmin Kim
Journal of Acute Care Surgery.2025; 15(3): 99. CrossRef
Risk Factors for Mortality Among Patients With Fournier Gangrene: A Systematic Review
Pavan Shet, Ashmit Daiyan Mustafa, Karan Varshney, Lavina Rao, Sameen Sawdagar, Florence McLennan, Siraaj Ansari, Darshan Shet, Niveshan Sivathamboo, Sian Campbell
Surgical Infections.2024; 25(4): 261. CrossRef

CPR/Resuscitation
Association between C-reactive protein-to-albumin ratio and 6-month mortality in out-of-hospital cardiac arrest: Hui Hwan Kim, Ji Ho Lee, Dong Hun Lee, Byung Kook Lee; Acute Crit Care. 2022;37(4):601-609. Published online August 18, 2022; DOI: https://doi.org/10.4266/acc.2022.00542

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Abstract PDF Supplementary Material

Background
The inflammatory response that occurs following cardiac arrest can determine the long-term prognosis of patients who survive out-of-hospital cardiac arrest. We evaluated the correlation between C-reactive protein-to-albumin ratio (CAR) following cardiac arrest and long-term mortality.
Methods
The current retrospective observational study examined patients with post-cardiac arrest syndrome (PCAS) treated with targeted temperature management at a single tertiary care hospital. We measured CAR at four time points (at admission and then 24 hours, 48 hours, and 72 hours after) following cardiac arrest. The primary outcome was the patients’ 6-month mortality. We performed multivariable and area under the receiver operating characteristic curve (AUC) analyses to investigate the relationship between CAR and 6-month mortality.
Results
Among the 115 patients, 52 (44.1%) died within 6 months. In the multivariable analysis, CAR at 48 hours (odds ratio [OR], 1.130; 95% confidence interval [CI], 1.027–1.244) and 72 hours (OR, 1.241; 95% CI, 1.059–1.455) after cardiac arrest was independently associated with 6-month mortality. The AUCs of CAR at admission and 24, 48, and 72 hours after cardiac arrest for predicting 6-month mortality were 0.583 (95% CI, 0.489–0.673), 0.622 (95% CI, 0.528–0.710), 0.706 (95% CI, 0.615–0.786), and 0.762 (95% CI, 0.675–0.835), respectively.
Conclusions
CAR at 72 hours after cardiac arrest was an independent predictor for long-term mortality in patients with PCAS.

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Association of Serial Lactate-to-Albumin and C-Reactive Protein-to-Albumin Ratios with In-Hospital Mortality After Out-of-Hospital Cardiac Arrest
Wan Young Heo, Dong Hun Lee, Seok Jin Ryu, Byung Kook Lee, Yong Hun Jung, Kyung Woon Jeung
Journal of Clinical Medicine.2026; 15(13): 4851. CrossRef
C-reactive protein-to-albumin ratio is associated with mortality after transcatheter tricuspid valve repair
Karl Finke, Laura Marx, Jan Althoff, Thorsten Gietzen, Matthieu Schäfer, Jan Wrobel, Philipp von Stein, Jennifer von Stein, Maria Isabel Körber, Stephan Baldus, Roman Pfister, Christos Iliadis
Clinical Research in Cardiology.2025; 114(7): 892. CrossRef
Biomarkers in Cardiac Arrest: A Narrative Review
Rohin Singla, Chelsey Sidaras, Jignesh K. Patel
Therapeutic Advances in Pulmonary and Critical Care Medicine.2025;[Epub] CrossRef
Association of the blood urea nitrogen to serum albumin ratio and 28-day all-cause mortality in patients with cardiac arrest: a retrospective cohort study using the MIMIC-IV database
Gaosheng Zhou, Yayuan Tan, Xueli Li, Yixun Wang, Dingdeng Wang, Min Liu
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef
Associations of C-reactive protein/albumin ratio with frailty and the risk of mortality: An observational study
Yaying Xu, Peng Tian, Ying Xu
Medicine.2025; 104(43): e45329. CrossRef
C-reactive protein-to-albumin ratio as a novel prognostic biomarker for long-term mortality in pericarditis: a real-world study
Lingyu Mi, Ishan Lakhani, Sharen Lee, Wing Tak Wong, Gary Tse, Fang Fang
BMC Cardiovascular Disorders.2025;[Epub] CrossRef
The association between C-reactive protein to albumin ratio and 6-month neurological outcome in patients with in-hospital cardiac arrest
Ji Ho Lee, Dong Hun Lee, Byung Kook Lee, Seok Jin Ryu
World Journal of Emergency Medicine.2024; 15(3): 223. CrossRef
Machine Learning and Clinical Predictors of Mortality in Cardiac Arrest Patients: A Comprehensive Analysis
Łukasz Lewandowski, Michał Czapla, Izabella Uchmanowicz, Grzegorz Kubielas, Stanisław Zieliński, Małgorzata Krzystek-Korpacka, Catherine Ross, Raúl Juárez-Vela, Marzena Zielińska
Medical Science Monitor.2024;[Epub] CrossRef
Inflammatory response after out‐of‐hospital cardiac arrest—Impact on outcome and organ failure development
Asser M. J. Seppä, Markus B. Skrifvars, Pirkka T. Pekkarinen
Acta Anaesthesiologica Scandinavica.2023; 67(9): 1273. CrossRef
Comparison of Prognostic Performance between Procalcitonin and Procalcitonin-to-Albumin Ratio in Post Cardiac Arrest Syndrome
Ju Hee Yoon, Woo Sung Choi, Yong Su Lim, Jae Ho Jang
Journal of Clinical Medicine.2023; 12(14): 4568. CrossRef
C-reactive protein-to-albumin ratio as a biomarker in patients with sepsis: a novel LASSO-COX based prognostic nomogram
Xin Zhou, Shouzhi Fu, Yisi Wu, Zhenhui Guo, Wankang Dian, Huibin Sun, Youxia Liao
Scientific Reports.2023;[Epub] CrossRef

Trauma
C-reactive protein-albumin ratio and procalcitonin in predicting intensive care unit mortality in traumatic brain injury: Canan Gürsoy, Güven Gürsoy, Semra Gümüş Demirbilek; Acute Crit Care. 2022;37(3):462-467. Published online August 5, 2022; DOI: https://doi.org/10.4266/acc.2022.00052

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Abstract PDF

Background
Prediction of intensive care unit (ICU) mortality in traumatic brain injury (TBI), which is a common cause of death in children and young adults, is important for injury management. Neuroinflammation is responsible for both primary and secondary brain injury, and C-reactive protein-albumin ratio (CAR) has allowed use of biomarkers such as procalcitonin (PCT) in predicting mortality. Here, we compared the performance of CAR and PCT in predicting ICU mortality in TBI.
Methods
Adults with TBI were enrolled in our study. The medical records of 82 isolated TBI patients were reviewed retrospectively.
Results
The mean patient age was 49.0 ± 22.69 years; 59 of all patients (72%) were discharged, and 23 (28%) died. There was a statistically significant difference between PCT and CAR values according to mortality (P<0.05). The area under the curve (AUC) was 0.646 with 0.071 standard error for PCT and 0.642 with 0.066 standard error for CAR. The PCT showed a similar AUC of the receiver operating characteristic to CAR.
Conclusions
This study shows that CAR and PCT are usable biomarkers to predict ICU mortality in TBI. When the determined cut-off values are used to predict the course of the disease, the CAR and PCT biomarkers will provide more effective information for treatment planning and for preparation of the family for the treatment process and to manage their outcome expectations.

Citations

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Performance and accuracy of blood glucose and neutrophil-lymphocyte ratio as predictors of mortality in children and adolescents with traumatic brain injury
José Roberto Tude Melo, Caio Vinicius de Almeida Chaves, Cindy Kawano, Isabela Zampirolli Leal, Maria Antonia Coladeti Fernandes, Stephannie Monaco Bodra, Jean Gonçalves de Oliveira, José Carlos Esteves Veiga
Child's Nervous System.2026;[Epub] CrossRef
Prognostic value of CAR, FIB-4, and procalcitonin in subdural hematoma: associations with mortality and 90-day functional outcomes running title: CAR, FIB-4, and procalcitonin in SDH outcomes
Tamer Tamdoğan, İlke Tamdoğan
Journal of Health Sciences and Medicine.2026; 9(1): 19. CrossRef
Association of Serial Lactate-to-Albumin and C-Reactive Protein-to-Albumin Ratios with In-Hospital Mortality After Out-of-Hospital Cardiac Arrest
Wan Young Heo, Dong Hun Lee, Seok Jin Ryu, Byung Kook Lee, Yong Hun Jung, Kyung Woon Jeung
Journal of Clinical Medicine.2026; 15(13): 4851. CrossRef
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Nermin Mutlu Bilgiç, Güldan Kahveci, Ekmel Burak Özşenel, Sema Basat
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Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
Zi-Yan Wang, Wei Du, Xian-Zhi Liu, Yuan Li, Jun Liu
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Prognostic value of procalcitonin and IL-6 with a composite model in moderate-severe traumatic brain injury
Xin-meng Li, Zi-wei Liu, Wei-yu Liu, Gao-jian Su, Xian-jian Huang
Journal of Clinical Neuroscience.2025; 140: 111516. CrossRef
Development and validation of a prediction model for pulmonary infection in elderly patients with traumatic brain injury
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Neurochirurgie.2025; 71(6): 101733. CrossRef
Albuminemia as a Potential Predictor of Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI)
Luka Stepanovic, Usha Govindarajulu, George Agriantonis, Navin D. Bhatia, Jasmine Dave, Shalini Arora, Zahra Shafaee, Kate Twelker, Jennifer Whittington, Bharti Sharma
Journal of Clinical Medicine.2025; 14(21): 7499. CrossRef
Research Advances in CAR, NLR, and S100β for Assessing Neurological Functional Prognosis in Traumatic Brain Injury Patients
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Symptoms and Functional Outcomes Among Traumatic Brain Injury Patients 3- to 12-Months Post-Injury
Kathryn S. Gerber, Gemayaret Alvarez, Arsham Alamian, Victoria Behar-Zusman, Charles A. Downs
Journal of Trauma Nursing.2024; 31(2): 72. CrossRef
Association of C-reactive protein/albumin ratio with mortality in patients with Traumatic Brain Injury: A systematic review and meta-analysis
Yuyang Liu, Yaheng Tan, Jun Wan, Qiwen Chen, Yuxin Zheng, Wenhao Xu, Peng Wang, Weelic Chong, Xueying Yu, Yu Zhang
Heliyon.2024; 10(13): e33460. CrossRef

Liver
The role of bilirubin to albumin ratio as a predictor for mortality in critically ill patients without existing liver or biliary tract disease: Ji Soo Choi, Kyung Soo Chung, Eun Hye Lee, Su Hwan Lee, Sang Hoon Lee, Song Yee Kim, Ji Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Joon Chang, Ah Young Leem; Acute Crit Care. 2020;35(1):24-30. Published online February 29, 2020; DOI: https://doi.org/10.4266/acc.2019.00738

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Background
Hyperbilirubinemia and hypoalbuminemia are frequently appeared and associated with poor prognosis in critically ill patients. We aim to evaluate the association between the bilirubin to albumin ratio and prognosis in intensive care unit (ICU) patients. Methods: This was a retrospective study of 731 patients who were admitted to the medical intensive care unit (MICU) at a tertiary-care center from July 2015 to September 2017. We analyzed the bilirubin to albumin ratio on admission to the MICU, including clinical characteristics and other examinations. Results: The overall 28-day survival of MICU patients was 69.1%. On univariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score (P<0.001), Sequential Organ Failure Assessment score (P<0.001), Simplified Acute Physiology Score II score (P<0.001), Creactive protein (P=0.015), and bilirubin/albumin ratio (P<0.001) were associated with mortality of ICU patients. The receiver operating characteristic curves for ICU patients mortality between bilirubin to albumin ratio and APACHE II score were not statistically significant (P=0.282). On multivariate analysis, higher APACHE II score (hazard ratio [HR], 1.05; 95% CI, 1.03 to 1.06; P<0.001) and bilirubin to albumin ratio (HR, 1.65; 95% CI, 1.23 to 2.20; P=0.001) were independently related to the ICU patient mortality. Conclusions: A higher bilirubin to albumin ratio was related to the unfavorable prognosis and mortality in critically ill patients.

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Anakath M Ijas, Gayathry Rajasekharan, Chinthu Sara Jacob , Vijayakumar Anil, Rajasekharan Chandrasekharan
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Jophin John, V. Arul Selvan, A. Senthil Vadivu, T. Ravishankar
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Pediatric
Serum Albumin as a Biomarker of Poor Prognosis in the Pediatric Patients in Intensive Care Unit: Young Suh Kim, In Suk Sol, Min Jung Kim, Soo Yeon Kim, Jong Deok Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim; Korean J Crit Care Med. 2017;32(4):347-355. Published online November 30, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00437

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Abstract PDF Supplementary Material

Background
Serum albumin as an indicator of the disease severity and mortality is suggested in adult patients, but its role in pediatric patients has not been established. The objectives of this study are to investigate the albumin level as a biomarker of poor prognosis and to compare it with other mortality predictive indices in children in intensive care unit (ICU).
Methods
Medical records of 431 children admitted to the ICU at Severance Hospital from January 1, 2012 to December 31, 2015 were retrospectively analyzed. Children who expired within 24 hours after ICU admission, children with hepatic or renal failure, and those who received albumin replacement before ICU admission were excluded.
Results
The children with hypoalbuminemia had higher 28-day mortality rate (24.60% vs. 9.28%, P < 0.001), Pediatric Index of Mortality (PIM) 3 score (9.23 vs. 8.36, P < 0.001), Pediatric Risk of Mortality (PRISM) III score (7.0 vs. 5.0, P < 0.001), incidence of septic shock (12% vs. 3%, P < 0.001), C-reactive protein (33.0 mg/L vs. 5.8 mg/L, P < 0.001), delta neutrophil index (2.0% vs. 0.6%, P < 0.001), lactate level (1.6 mmol/L vs. 1.2 mmol/L, P < 0.001) and lower platelet level (206,000/μl vs. 341,000/μl, P < 0.001) compared to the children with normal albumin level. PIM 3 (r = 0.219, P < 0.001) and PRISM III (r = 0.375, P < 0.001) were negatively correlated with serum albumin level, respectively.
Conclusions
Our results highlight that hypoalbuminemia can be a biomarker of poor prognosis including mortality in the children in ICU.

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Journal of Clinical Medicine.2026; 15(10): 3594. CrossRef
Hypoalbuminemia is associated with adverse outcomes in critically ill children with cancer
Vinson James, Emily Ashcraft, Cheng Cheng, Lama Elbahlawan
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Case Report

Liver/Infection
Chylous Ascites in a Patient with Sepsis Caused by Bilateral Pneumonia: Yong Dae Lee, Young Hyun Lee, Hye Sook Choi; Korean J Crit Care Med. 2014;29(3):217-221. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.217

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Abstract PDF

Chylous ascites is a rare form of ascites characterized by milky peritoneal fluid rich in triglycerides due to the accumulation of chyle in the peritoneal cavity. This affliction occurs as a result of a disruption of lymph flow associated with traumatic injury or obstruction of the lymphatic system. There are various causes of chylous ascites, such as lymphatic anomalies, malignancy, cirrhosis, infection, trauma, surgery, and nephrotic syndrome. We report a rare case of an 81-year-old male with sepsis caused by bilateral pneumonia who presented with chylous ascites.

Citations

Citations to this article as recorded by

Disorders of Lymphatic Architecture and Flow in Critical Illness
Maxim Itkin, Jiri Horak, Jose L. Pascual, Cherylee W. J. Chang, Deacon Lile, Beverly Tomita, Gary Alan Bass, Stephen J. Kovach, Lewis J. Kaplan
Critical Care Medicine.2025; 53(3): e665. CrossRef
Diagnostic and management problems of chylous effusion in a patient with newly-diagnosed tuberculosis
Dicky Febrianto, Usman Hadi
Current Internal Medicine Research and Practice Surabaya Journal.2021; 2(2): 35. CrossRef

Original Article

Clinical Significance of Postoperative Prealbumin and Albumin Levels in Critically Ill Patients who Underwent Emergency Surgery for Acute Peritonitis: Seung Hwan Lee, Ji Young Jang, Jae Gil Lee; Korean J Crit Care Med. 2013;28(4):247-254.; DOI: https://doi.org/10.4266/kjccm.2013.28.4.247

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Abstract PDF

BACKGROUND
Many studies have shown that serum albumin and prealbumin levels correlate with patient outcomes in critically ill patients. The purpose of this study was to evaluate the clinical significance of prealbumin and albumin levels in patients in the intensive care unit (ICU) after emergency surgery for acute peritonitis.
METHODS
We examined serum albumin and prealbumin as markers for the prediction of patient outcome in 51 patients admitted to the ICU after emergency surgery from January to December in 2012. Biochemical parameters were measured postoperatively. Serum albumin and prealbumin levels were compared between survivors and non-survivors. Patients were also divided according to the occurrence of shock and pulmonary complications (shock group vs. non-shock group, pulmonary complications group vs. non-pulmonary complications group), and outcome analysis was performed for age, American Society of Anesthesiologists (ASA) score, length of ICU stay (IS), length of hospital stay (HS), mechanical ventilation, and APACHE II score. Serum albumin and prealbumin levels were evaluated for any correlation with complications and mortality.
RESULTS
In patients with shock, prealbumin and albumin were significantly decreased (p = 0.047, p = 0.036). Additionally, albumin was significantly decreased in patients with pulmonary complications. Neither albumin nor prealbumin, however, showed a correlation with mortality. Prealbumin showed a correlation with serum albumin, CRP level, and HS (r = 0.511, p < 0.001; r = -0.438, p = 0.002; and r = -0.45, p = 0.001, respectively). Albumin showed a correlation with HS, IS, and APACHE II score (r = -0.404, p = 0.003; r = -0.424, p = 0.002; and r = -0.40, p = 0.006, respectively).
CONCLUSIONS
The initial prealbumin level measured upon admission to the ICU after gastrointestinal emergency surgery can be useful predictor of shock. The initial albumin level was significantly low in patients with shock and pulmonary complications. However, neither prealbumin nor albumin showed a correlation with mortality. Our study also showed that albumin and prealbumin levels are affected by other factors, such as massive hydration and severe inflammation, as reported in previous studies.

Citations

Citations to this article as recorded by

Perioperative risk factors for in-hospital mortality after emergency gastrointestinal surgery
Jin Young Lee, Seung Hwan Lee, Myung Jae Jung, Jae Gil Lee
Medicine.2016; 95(35): e4530. CrossRef

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