Biomarkers in medicine · 2025
Phenotype-specific dynamics of serum albumin and their impact on sepsis mortality.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Turcato Gianni, Zaboli Arian, Filippi Lucia, Ferretto Paolo, Milazzo Daniela, Maggi Michael, Cipriano Alessandro, Marchetti Massimo, Ghiadoni Lorenzo, Wiedermann Christian J
Аннотация
AIMS: To assess the prognostic value of serial serum albumin measurements in septic patients, with a focus on different clinical phenotypes.
METHODS: We conducted a prospective observational study involving 254 patients with sepsis admitted to an Intermediate Care Unit in Italy (September 2022-June 2024). Patients were classified into four sepsis phenotypes (α, β, γ, δ), and serum albumin levels were measured daily over five days. The primary outcome was 30-day mortality. Logistic regression, Cox models, and AUROC analysis were used to evaluate associations between albumin dynamics, phenotypes, and outcomes.
RESULTS: The δ phenotype showed the lowest mean albumin levels (2.2 g/dL) and the highest mortality (45.4%), while phenotype α had the highest albumin and lowest mortality (3.6%). Each 1 g/dL increase in albumin was associated with a 63% mortality risk reduction (HR 0.37; 95% CI: 0.24-0.56). Albumin's predictive performance was strongest in the δ phenotype (AUROC up to 0.95).
CONCLUSION: Serial albumin monitoring may provide prognostic insights in sepsis, especially in phenotypes associated with endothelial dysfunction. These results are hypothesis-generating and may support more personalized treatment strategies.
METHODS: We conducted a prospective observational study involving 254 patients with sepsis admitted to an Intermediate Care Unit in Italy (September 2022-June 2024). Patients were classified into four sepsis phenotypes (α, β, γ, δ), and serum albumin levels were measured daily over five days. The primary outcome was 30-day mortality. Logistic regression, Cox models, and AUROC analysis were used to evaluate associations between albumin dynamics, phenotypes, and outcomes.
RESULTS: The δ phenotype showed the lowest mean albumin levels (2.2 g/dL) and the highest mortality (45.4%), while phenotype α had the highest albumin and lowest mortality (3.6%). Each 1 g/dL increase in albumin was associated with a 63% mortality risk reduction (HR 0.37; 95% CI: 0.24-0.56). Albumin's predictive performance was strongest in the δ phenotype (AUROC up to 0.95).
CONCLUSION: Serial albumin monitoring may provide prognostic insights in sepsis, especially in phenotypes associated with endothelial dysfunction. These results are hypothesis-generating and may support more personalized treatment strategies.