Study on the Prevalence of Hypoalbuminemia and their Clinical Outcome in Critically Ill Children Admitted to PICU in Tertiary Care Hospital

Introduction: Hypoalbuminemia is a frequent and early biochemical derangement in critically ill-patients and is considered as a marker of disease severity and predictor of increased morbidity and mortality.The objective of the study is to evaluate prevalence of hypoalbuminemia and its association with disease severity and clinical outcome of illness in critically ill children.Methods: A prospective observational study conducted at the PICU of Tertiary care Hospital.Children aged 1year to 12 years admitted to PICU were included.Serum albumin levels were estimated at the time of admission to PICU.Children who expired within 24 hours after ICU admission, children with hepatic or renal failure, and those who received albumin replacement before ICU admission were excluded.Pediatric risk of mortality III (PRISM-III) scoring system was used to assess the severity of illness at admission.Results: The prevalence of hypoalbuminemia at admission was 38%.Mean serum albumin level in this study was 2.54 ± 0.38 g/dl.A lower s.albumin concentration correlated well with higher rates of complications such as ventilator dependency and development of new infections leading to longer length of PICU stay and higher mortality (31.5%).The mean length of PICU stay (8.6 ± 5.1; p<0.001) was statistically longer than those with normal albumin.A Strong negative correlation(r= -0.867) found between s.albumin level and the mortality rate.Conclusion: Hypoalbuminemia at admission can be helpful for risk assessment and can be used as an outcome predictor in critically ill children.