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Hypoalbuminemia and Early Mortality After Lung Transplantation: A Cohort Study |
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| Authors: | M. R. Baldwin S. M. Arcasoy A. Shah P. C. Schulze J. Sze J. R. Sonett D. J. Lederer |
| Affiliation: | 1. Departments of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY;2. Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, MD;3. New York Presbyterian Hospital, New York, NY;4. Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY;5. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY |
| Abstract: | Hypoalbuminemia predicts disability and mortality in patients with various illnesses and in the elderly. The association between serum albumin concentration at the time of listing for lung transplantation and the rate of death after lung transplantation is unknown. We examined 6808 adults who underwent lung transplantation in the United States between 2000 and 2008. We used Cox proportional hazard models and generalized additive models to examine multivariable‐adjusted associations between serum albumin and the rate of death after transplantation. The median follow‐up time was 2.7 years. Those with severe (0.5–2.9 g/dL) and mild hypoalbuminemia (3.0–3.6 g/dL) had posttransplant adjusted mortality rate ratios of 1.35 (95% CI: 1.12–1.62) and 1.15 (95% CI: 1.04–1.27), respectively. For each 0.5 g/dL decrease in serum albumin concentration the 1‐year and overall mortality rate ratios were 1.48 (95% CI: 1.21–1.81) and 1.26 (95% CI: 1.11–1.43), respectively. The association between hypoalbuminemia and posttransplant mortality was strongest in recipients with cystic fibrosis and interstitial lung disease. Hypoalbuminemia is an independent risk factor for death after lung transplantation. |
| Keywords: | Cystic fibrosis hypoalbuminemia interstitial lung disease lung transplantation prognosis |