Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Low serum albumin levels predict poor outcome in patients with acute ischaemic stroke or transient ischaemic attack
First author：Hongyu Zhou,Anxin Wang
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Hongyu Zhou,Anxin Wang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20200034
- Published time：2021-02-25
2021-02-25
Published articles
Journal：Stroke and Vascular Neurology
Publication type: Original Contributions
IF(IF): 4.081
PMID: 33632730 Link To Pubmed Full text Download
Background And Purpose
Low serum albumin is an independent predictor of poor prognosis in ischemic cardio-cerebrovascular disease1, 2. Meanwhile, several studies suggested that high serum albumin may be neuroprotective in ischemic stroke in humans3, 4. It may be related to the physiological properties of serum albumin, such as anti-inflammation, antioxidation, anticoagulation, anti-platelet aggregation activity and colloid permeability5. We aimed to confirm the relationship between plasma albumin and the prognosis of ischemic cerebrovascular disease, and try to analyze the etiology and biological pathway.
Method
We analyzed data from the Third China National Stroke Registry (CNSR-Ⅲ). Patients were divided into four groups based on serum albumin levels at admission. The outcomes included poor functional outcome (mRS of 3 to 6) and mortality at 3 months and 1 year. Multiple logistic regression models and Cox regression models were used to evaluate the association, respectively. We used a fixed-effect model to calculate the risk ratio for poor functional outcome, and a random-effect model for mortality in the meta-analysis.
Conclusion
Low serum albumin levels predict poor functional outcome and mortality in patients with AIS or TIA.
Main results
A total of 13618 patients were enrolled. During the 3-mo follow-up period, compared with 40 to 44.9 g/L group, patients in < 35g/L group had an increased risk of poor functional outcome and mortality (adjusted OR 1.37 (95%CI 1.12 to1.67); adjusted HR 2.13 (95%CI 1.41 to 3.23)). The relationship in per 10 g/L decreased serum albumin with prognosis was consistently inversed (adjusted OR 1.17 (95%CI 1.01 to 1.35); adjusted HR 1.86 (95%CI 1.30 to 2.64)). Also, low serum albumin levels were independently correlated with clinical outcomes at 1 year. In the meta-analysis, the OR for poor functional outcome pooled 3 studies per 1 g/L decrease was 1.03 (95% CI 1.02 to 1.05), and the HR for mortality pooled 5 studies was 1.07 (95% CI 1.03 to 1.11).