NYMC Faculty Publications

Low Serum Albumin as a Risk Factor for Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: Eicu Collaborative Research Database Analysis

Author Type(s)

Resident/Fellow, Faculty

DOI

10.23736/S0390-5616.22.05604-1

Journal Title

Journal of Neurosurgical Sciences

First Page

287

Last Page

293

Document Type

Article

Publication Date

6-1-2024

Department

Neurosurgery

Second Department

Neurology

Keywords

Albumins, Brain ischemia, Database, Subarachnoid hemorrhage

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND: Delayed cerebral ischemia (DCI) represents a devastating complication of aneurysmal subarachnoid hemorrhage (aSAH) and is a significant predictor of morbidity and mortality. Recent studies have implicated inflammatory processes in the pathogenesis of DCI. METHODS: aSAH patient data were retrospectively obtained from the eICU Collaborative Research Database (eICU CRD). Multivariable logistic regression models and receiver operating characteristic (ROC) curve analyses were employed to assess the association between low serum albumin (<3.4 g/dL) and clinical endpoints: DCI and in-hospital mortality. RESULTS: Among 276 aSAH patients included in the analysis, 35.5% (N.=98) presented with low serum albumin levels and demonstrated a higher incidence of DCI (18.4% vs. 8.4%, OR=2.45, 95% CI=1.17, 5.10; P=0.017) and in-hospital mortality (27.6% vs. 16.3%, OR=1.95, 95% CI=1.08, 3.54; P=0.027) compared to patients with normal admission albumin values. In a multivariable model controlling for age and World Federation of Neurosurgical Societies grade, low serum albumin remained significantly associated with DCI (OR=2.52, 95% CI=1.18, 5.36; P=0.017), but not with in-hospital mortality. A combined model for prediction of DCI, encompassing known risk factors in addition to low serum albumin, achieved an area under the curve of 0.65 (sensitivity = 0.55, specificity = 0.75). CONCLUSIONS: Serum albumin, a routine and inexpensive laboratory measurement, may potentially aid in the identification of patients with aSAH at risk for the development of DCI.

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