The impact of albumin infusion on the risk of rebleeding and in-hospital mortality in cirrhotic patients admitted for acute gastrointestinal bleeding: a retrospective study of a single institute
Background: To investigate the effect of albumin infusion on cirrhotic patients admitted for acute gastrointestinal bleeding.
Methods: Medical records of cirrhotic patients who admitted due to acute gastrointestinal bleeding through January 2009 to December 2018 were reviewed. Clinical data and the total amount of albumin and red blood cell used during hospitalization were recorded. For patients with rebleeding, the amount of albumin and red blood cell used before rebleeding was also documented. The primary outcome was the occurrence of rebleeding, and the second outcome was in-hospital mortality. Univariate and multivariate logistic analysis was performed to identify risk factors associated with rebleeding and in-hospital mortality.
Results: A total of 1503 cirrhotic patients were included in the analysis. There were 146 episodes of in-patient rebleeding occurred, while 81 patients died. Overall, more red blood cells and albumin were prescribed to patients who suffered rebleeding. In terms of the amount before rebleeding, the red blood cell was higher in patients with rebleeding, but the albumin infusion was similar. In the multivariate model, the albumin infusion was an independent risk factor associated with rebleeding (adjusted OR for ≤40g vs 0g, 0.469 [0.274-0.805], p=0.006; adjusted OR for >40g vs 0g, 0.272 [0.122-0.604], p=0.001). In Child-Pugh C class patients, the use of albumin more than 40g during hospitalization associated with a lower risk of in-patient mortality (adjusted OR for >40g vs 0g, 0.136 [0.019-0.741], p=0.031).
Conclusions: Albumin infusion was associated with a lower risk of rebleeding and in-hospital deaths in cirrhosis admitted for acute gastrointestinal bleeding.
Figure 1
Figure 2
Posted 15 May, 2020
On 19 Apr, 2020
On 16 Apr, 2020
On 15 Apr, 2020
On 15 Apr, 2020
On 13 Mar, 2020
Received 08 Mar, 2020
Received 24 Jan, 2020
On 14 Jan, 2020
On 11 Jan, 2020
Invitations sent on 11 Jan, 2020
On 11 Jan, 2020
On 08 Jan, 2020
On 08 Jan, 2020
On 24 Dec, 2019
The impact of albumin infusion on the risk of rebleeding and in-hospital mortality in cirrhotic patients admitted for acute gastrointestinal bleeding: a retrospective study of a single institute
Posted 15 May, 2020
On 19 Apr, 2020
On 16 Apr, 2020
On 15 Apr, 2020
On 15 Apr, 2020
On 13 Mar, 2020
Received 08 Mar, 2020
Received 24 Jan, 2020
On 14 Jan, 2020
On 11 Jan, 2020
Invitations sent on 11 Jan, 2020
On 11 Jan, 2020
On 08 Jan, 2020
On 08 Jan, 2020
On 24 Dec, 2019
Background: To investigate the effect of albumin infusion on cirrhotic patients admitted for acute gastrointestinal bleeding.
Methods: Medical records of cirrhotic patients who admitted due to acute gastrointestinal bleeding through January 2009 to December 2018 were reviewed. Clinical data and the total amount of albumin and red blood cell used during hospitalization were recorded. For patients with rebleeding, the amount of albumin and red blood cell used before rebleeding was also documented. The primary outcome was the occurrence of rebleeding, and the second outcome was in-hospital mortality. Univariate and multivariate logistic analysis was performed to identify risk factors associated with rebleeding and in-hospital mortality.
Results: A total of 1503 cirrhotic patients were included in the analysis. There were 146 episodes of in-patient rebleeding occurred, while 81 patients died. Overall, more red blood cells and albumin were prescribed to patients who suffered rebleeding. In terms of the amount before rebleeding, the red blood cell was higher in patients with rebleeding, but the albumin infusion was similar. In the multivariate model, the albumin infusion was an independent risk factor associated with rebleeding (adjusted OR for ≤40g vs 0g, 0.469 [0.274-0.805], p=0.006; adjusted OR for >40g vs 0g, 0.272 [0.122-0.604], p=0.001). In Child-Pugh C class patients, the use of albumin more than 40g during hospitalization associated with a lower risk of in-patient mortality (adjusted OR for >40g vs 0g, 0.136 [0.019-0.741], p=0.031).
Conclusions: Albumin infusion was associated with a lower risk of rebleeding and in-hospital deaths in cirrhosis admitted for acute gastrointestinal bleeding.
Figure 1
Figure 2